Evidence map›Paper›PMID 40830593›Full record

ArticlePediatric surgery international2025

Adjuvant steroids following Kasai portoenterostomy for biliary atresia: a single-center 18-year experience comparing different steroid dose regimens.

Norah E Liang, Enrico Danzer, Jeong S Hyun, Stephanie D Chao, Matias Bruzoni, James C Y Dunn

Abstract readComparative Study
PubMed Publisher
In one paragraph

Article in Pediatric surgery international, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

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No citing paper in PubMed yet.

4 · The record

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5 · Who and what money

Authors and funding

6 authors.

Norah E Liang *Department of Surgery, Division of Pediatric Surgery, Stanford University School of Medicine, 257 Campus Drive, Stanford, CA, 94305, USA. nliang@stanford.edu.
Enrico Danzer *Department of Surgery, Division of Pediatric Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA.
Jeong S HyunDepartment of Surgery, Division of Pediatric Surgery, Stanford University School of Medicine, 257 Campus Drive, Stanford, CA, 94305, USA.
Stephanie D ChaoDepartment of Surgery, Division of Pediatric Surgery, Stanford University School of Medicine, 257 Campus Drive, Stanford, CA, 94305, USA.
Matias Bruzoni *Department of Surgery, Division of Pediatric Surgery, Texas Children's Hospital Austin, Austin, TX, 78717, USA.
James C Y Dunn *Department of Surgery, Division of Pediatric Surgery, Stanford University School of Medicine, 257 Campus Drive, Stanford, CA, 94305, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeIn 2017, our hospital transitioned to a standardized post-KPE high-dose steroid protocol. We sought to compare outcomes for biliary atresia (BA) for this protocol against historical treatment with no or low-dose steroids.

methodsBetween 2006 and 2024, 50 children underwent KPE for BA. Patients were stratified into three groups: no steroids, low-dose steroids (defined by a starting dose of 2-4 mg/kg/day), and high-dose steroids (starting dose of 10 mg/kg/day). After the initial taper, patients in both steroid groups continued with 2 mg/kg/day for 4-6 weeks.

results8 patients received no steroids, 21 received low-dose steroids, and 21 received high-dose steroids. Patients treated with high-dose steroids had significantly greater readmission rates compared to the no or low-dose steroid cohorts. There was an overall trend towards improved native liver survival for the high-dose steroid cohort at 1 and 5 years after KPE. There was no significant difference in rates of cholangitis, though the high-dose cohort tended to present with cholangitis within 30 days of discharge.

conclusionsWe describe the 18-year experience of adjuvant steroid use in BA patients at a single institution. We show improved early postoperative biliary drainage with high-dose steroid use and identify a trend towards improved native liver survival with high-dose steroids.

Indexed as

Biliary AtresiaGlucocorticoidsPortoenterostomy, HepaticChemotherapy, AdjuvantCholangitisDose-Response Relationship, DrugDrug TaperingFemaleHumansInfantLength of StayLiver TransplantationMalePatient ReadmissionReoperationRetrospective StudiesGlucocorticoidsBiliary atresiaCholangitisKasai portoenterostomyNative liver survivalSteroids

Identifiers

PMID40830593

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.