ArticleBMC surgery2026
Technique and early outcomes of total laparoscopic Kasai portoenterostomy in Type III biliary atresia.
Article in BMC surgery, 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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Abstract
purposeTo evaluate the early outcomes of total laparoscopic Kasai portoenterostomy (TL-KPE) for Type III biliary atresia (BA).
methodsA retrospective analysis included 45 pediatric patients with Type III BA who underwent Kasai portoenterostomy between January 2018 and December 2024. Patients were divided into three groups (n = 15 each): open KPE (O-KPE), conventional laparoscopic KPE (L-KPE, with extracorporeal intestinal anastomosis), and TL-KPE (with fully intracorporeal anastomosis). Comparative parameters included operative time, intraoperative blood loss, postoperative recovery metrics, incidence of cholangitis within 6 months, jaundice clearance, and native liver survival rates.
resultsCompared with the O-KPE group, the TL-KPE group showed significantly less intraoperative blood loss (P = 0.016). Compared with both the O-KPE and L-KPE groups, the TL-KPE group had markedly shorter time to bowel recovery and postoperative fasting time (all P < 0.001). Postoperative hospital stay was also significantly shorter in the TL-KPE group compared to the O-KPE (P = 0.016) and L-KPE (P = 0.034) groups. There were no significant differences among the three groups in operative time (P = 0.052), incidence of postoperative complications (P = 0.132), jaundice clearance cases (P = 0.278), early cholangitis (P = 0.932), or recurrent cholangitis (P = 1.000). No perioperative deaths occurred in any group.
conclusionTL-KPE is a safe and technically feasible approach for Type III BA that enhances short-term postoperative recovery. These early results warrant further multicenter prospective studies with longer follow-up to evaluate potential long-term benefits on native liver survival.
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