Evidence map›Paper›PMID 41865321›Full record

ArticlePediatric surgery international2026

A national database study of adjuvant steroids following Kasai portoenterostomy for biliary atresia.

Norah E Liang, Humza Thobani, Anoosha Moturu, Elijah Suh, Saleem Islam, Gillian L Fell, Jeong S Hyun, Karl G Sylvester, Stephanie D Chao, James C Y Dunn and 1 more

Abstract readMulticenter Study
PubMed Publisher
In one paragraph

Article in Pediatric surgery international, 2026. 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

What it found

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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

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Norah E Liang *Department of Surgery, Division of Pediatric Surgery, Stanford University School of Medicine, Stanford, CA, 94305, USA.
Humza Thobani *Department of Surgery, Division of Pediatric Surgery, Stanford University School of Medicine, Stanford, CA, 94305, USA.
Anoosha MoturuDepartment of Surgery, Division of Pediatric Surgery, Stanford University School of Medicine, Stanford, CA, 94305, USA.
Elijah SuhDepartment of Surgery, Division of Pediatric Surgery, Stanford University School of Medicine, Stanford, CA, 94305, USA.
Saleem IslamDepartment of Surgery, Aga Khan University, Karachi, Pakistan.
Gillian L FellDepartment of Surgery, Division of Pediatric Surgery, Stanford University School of Medicine, Stanford, CA, 94305, USA.
Jeong S HyunDepartment of Surgery, Division of Pediatric Surgery, Stanford University School of Medicine, Stanford, CA, 94305, USA.
Karl G SylvesterDepartment of Surgery, Division of Pediatric Surgery, Stanford University School of Medicine, Stanford, CA, 94305, USA.
Stephanie D ChaoDepartment of Surgery, Division of Pediatric Surgery, Stanford University School of Medicine, Stanford, CA, 94305, USA.
James C Y DunnDepartment of Surgery, Division of Pediatric Surgery, Stanford University School of Medicine, Stanford, CA, 94305, USA.
Faraz A KhanDepartment of Surgery, Division of Pediatric Surgery, Stanford University School of Medicine, Stanford, CA, 94305, USA. fakhan1@stanford.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveAdjuvant steroids in the treatment of BA remains controversial. We sought to characterize variations in steroid use and their effect on postoperative outcomes in a multi-institutional cohort of BA patients. STUDY

designPHIS was queried for all patients between 2017 and 2024 who were diagnosed with BA and underwent KPE. Patients who received ≥ 3 contiguous days of steroids within 7 days of KPE were considered to have received postoperative steroids. The primary outcome was native liver survival, calculated using Kaplan-Meier analysis.

results504 patients from 37 hospitals with a median age of 52 days (IQR: 35-69 days) met inclusion criteria. 139 patients (28.6%) received adjuvant steroids. The steroid-treated cohort had a significantly longer postoperative LOS (P < 0.001) and high-volume-KPE hospitals were significantly more likely to use adjuvant steroids (P < 0.001). The majority of patients were started on steroids on POD#0. 5 hospitals utilized steroids in > 50% of their patients after KPE. Kaplan-Meier analysis showed no difference in two-year native liver survival.

conclusionIn this large multi-institutional cohort study, steroids were used early, with significant intra-hospital variation, and were associated with increased postoperative LOS and higher KPE volume. Larger multi-institutional studies with standardized steroid dosage regimens and extended long-term follow up are needed. LEVEL OF EVIDENCE: III.

Indexed as

Biliary AtresiaPortoenterostomy, HepaticSteroidsDatabases, FactualFemaleHumansInfantInfant, NewbornMaleRetrospective StudiesTreatment OutcomeUnited StatesSteroidsBiliary atresiaKasai portoenterostomyNative liver survivalPostoperative steroids

Identifiers

PMID41865321

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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.