A Comparison of Laparoscopic-Modified Kasai Versus Conventional Open Kasai for Biliary Atresia in Infants: A Single-Center Experience

Background: The purpose of this study was to evaluate the efficacy of our modified laparoscopic Kasai portoenterostomy for type III biliary atresia (BA) in children.Methods: A total of 56 type III BA patients underwent laparoscopic-modified Kasai procedure from January 2015 to July 2021. Conventionally control group of 45 BA patients from January 2012 to January 2016 were operated by open Kasai. The clinical data between the two groups were retrospectively compared.Results: The mean operating time was 235.5 +/- 20.5 minutes (range, 210-275 minutes) in Group I, whereas 180.5 +/- 25.5 minutes (range, 155-210 minutes) in Group II. The oral intake resumption was faster in Group I than that in Group II (mean 3.5 days versus 4.5 days). The follow-up time was mean 18.5 months in Group I and 24 months in Group II. The clearance of jaundice (total bilirubin <20 mu mol/L) was significant different in Group I (78.6%) (44/56) versus that of Group II (74.3%) (33/45). The native liver survival rate was 71.4% (40/56) in Group I and was 66.7% (30/45) in Group II at the follow-up time, respectively.Conclusion: The laparoscopic-modified Kasai would improve the outcome of BA patients.