ArticleBJS open2026
Liver mobilization during Kasai portoenterostomy: retrospective multicentre analysis.
Article in BJS open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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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.
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Who cites it
1 citing paper in PubMed.
- Standardised Transplant-Orientated Kasai Portoenterostomy in a Combined Kasai and Transplant Programme: An 11-Year Single-Surgeon Series of 74 Consecutive Cases.Journal of clinical medicine · 2026Article
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Authors and funding
17 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundLiver mobilization (LM) during Kasai portoenterostomy (KPE) is used by some surgeons to improve exposure but remains controversial due to anaesthetic challenges and concerns about increased adhesions complicating liver transplantation (LT). This study evaluated the impact of LM on intraoperative, postoperative, and long-term outcomes in biliary atresia.
methodsA multicentre case-control study involving high-volume biliary atresia centres in Europe and North America was conducted. Preoperative, intraoperative, and postoperative clinical and laboratory data were retrospectively collected and comparisons were made between groups with and without LM. Long-term native liver survival was assessed by Kaplan-Meier analysis with log-rank testing.
resultsIn all, 204 patients were included in the study: 142 in the LM group and 62 in the No LM group. During KPE, the LM group received catecholamines more frequently (100 (100%) versus 13 (46%) patients; P < 0.001), required more intravenous fluids (116.2 versus 79.15 ml/kg; P < 0.014), and had higher transfusion rates (18.91 versus 7.59 ml/kg; P < 0.001) than the No LM group. After KPE, transaminases were elevated in both groups, but significantly higher in the LM group (aspartate aminotransferase, 1166 versus 374.6 U/l; P < 0.001; alanine aminotransferase 456.8 versus 206.7 U/l; P < 0.001). These values normalized within 7 days after KPE. During subsequent LT, patients who had undergone LM experienced significantly shorter operative times (295.3 versus 509.8 minutes; P < 0.001) and required lower blood transfusion volumes (55.26 versus 95.81 ml/kg; P < 0.001). Of note, patients who underwent LM showed significantly prolonged native liver survival (P < 0.024).
conclusionsLM during KPE leads to increased intraoperative haemodynamic compromise requiring more intensive anaesthetic management and causes transient postoperative hepatic stress. LM does not appear to negatively affect LT and is associated with improved long-term native liver survival. These findings suggest potential benefits of LM during KPE, warranting further investigation in prospective studies.
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