Evidence map›Paper›PMID 40908322›Full record

ArticlePediatric surgery international2025

Evaluating the role of Kasai portoenterostomy in biliary atresia older than 90 days.

Yu Tian, Haoran Lian, Mao Ye, Yifeng Shao, Yuanyuan Geng, Zhen Chen, Shuai Chen, Xuli, Longli

Abstract readMulticenter 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. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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

1 citing paper in PubMed.

  1. Article
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

9 authors.

Yu Tian *Department of Pediatric Surgery, Capital Center for Children's Health, Capital Medical University, Capital Institute of Pediatrics, Beijing, 100020, China.
Haoran Lian *Precision Regenerative Medicine Research Centre, Medical Science Division, and State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Macao, 999078, China.
Mao YeDepartment of Pediatric Surgery, Capital Center for Children's Health, Capital Medical University, Capital Institute of Pediatrics, Beijing, 100020, China.
Yifeng ShaoDepartment of Pediatric Surgery, Capital Center for Children's Health, Capital Medical University, Capital Institute of Pediatrics, Beijing, 100020, China.
Yuanyuan GengDepartment of Pediatric Surgery, Capital Center for Children's Health, Capital Medical University, Capital Institute of Pediatrics, Beijing, 100020, China.
Zhen ChenDepartment of Pediatric Surgery, Capital Center for Children's Health, Capital Medical University, Capital Institute of Pediatrics, Beijing, 100020, China.
Shuai ChenDepartment of Neonatal Surgery, Children's Hospital Affiliated to Shandong University (Jinan Children's Hospital), Jinan, 250022, China. shuaishuai-wo@163.com.
XuliDepartment of Pediatric Surgery, Capital Center for Children's Health, Capital Medical University, Capital Institute of Pediatrics, Beijing, 100020, China. lixu622@163.com.
LongliDepartment of Pediatric Surgery, Capital Institute of Pediatrics-Peking University Teaching Hospital, Beijing, 100020, China. lilong23@126.com.

Funding

Beijing Municipal Science & Technology Commission Z191100006619002Haiyou Health High-Caliber Talent Project 202412Research Unit of Minimally Invasive Pediatric Surgery on Diagnosis and Treatment, Chinese Academy of Medical Sciences 2021RU015
6 · The paper itself

Abstract

purposeBiliary atresia (BA) patients presenting after 90 days of age face contentious treatment decisions between Kasai portoenterostomy and direct liver transplantation. This study evaluated outcomes of Kasai portoenterostomy in older BA patients to inform therapeutic decision-making.

methodsA retrospective multicenter study analyzed 32 BA patients who underwent Kasai portoenterostomy beyond 90 days of age. Primary outcomes included jaundice clearance (total bilirubin < 20 μmol/L) and two-year native liver survival. Patients were stratified by jaundice clearance status for comparative analysis.

resultsThe median surgical age was 110 days (IQR: 98-119 days). Twenty patients (62.5%) achieved jaundice clearance, while 12 (37.5%) failed to clear jaundice. All patients achieving jaundice clearance survived with their native Liver at two years, with only one requiring transplantation in the fourth postoperative year. Conversely, none of the non-clearance patients achieved two-year native Liver survival, with 11 undergoing transplantation for progressive cholestasis at a median of 5 months postoperatively and one death after declined transplantation. Surgical age was the most significant predictor of success, with ROC analysis yielding an optimal cutoff of 109 days (AUC: 0.779), while histological fibrosis stage also showed significant association with outcomes".

conclusionKasai portoenterostomy remains clinically meaningful in selected older BA patients, with 109 days representing a critical surgical threshold. This approach is particularly valuable in resource-limited settings where liver transplantation availability is constrained.

Indexed as

Biliary AtresiaPortoenterostomy, HepaticFemaleHumansInfantInfant, NewbornLiver TransplantationMaleRetrospective StudiesTreatment OutcomeBiliary atresiaJaundice clearanceKasai portoenterostomyLiver transplantationSurgical age

Identifiers

PMID40908322

What Socratic 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 Socratic graph.