Laparoscopic vs open Kasai procedure for biliary atresia: How do long-term outcomes compare?

Utilizing a laparoscopic Kasai procedure (LKP) resulted in inferior long-term outcomes when compared to open Kasai procedure (OKP) use in patients with biliary atresia, although the differences were not significant, according to a study.

In this randomized clinical trial, patients with biliary atresia type III were randomized to undergo LKP (n = 61) or OKP (n = 61). The groups had similar baseline characteristics and all surgical procedures were performed by the same surgeon with the same technical principles. Patients were followed up to 142 months.

At 6 months after surgery, the jaundice-free rate was 52.5% in the LKP group and 60.7% in the OKP group (P = 0.23).

The 10-year cumulative survival after LKP was 44.3% compared to 58.9% after OKP (P = 0.09).

Reference
Son TN, Mai DV, Tung PT, et al. Laparoscopic versus open Kasai procedure for biliary atresia: long-term results of a randomized clinical trial. Pediatr Surg Int. 2023;39(1):111. doi: 10.1007/s00383-023-05391-4. PMID: 36763200.