Kasai Porto Enterostomy outcome in Egypt; a single center study

Background: The goal of Kasai portoenterostomy (KPE) is to establish adequate bile drainage in patients with biliary atresia by excising the fibrous portal plate and creating a Roux-en-Y porto enteric anastomosis. This procedure aims to normalize bilirubin levels and achieve jaundice-free status. Various factors influence the success of KPE, including patient age, liver condition, associated anomalies, and surgical technique.Patients and Method: This retrospective descriptive study analyzed data from 51 patients who underwent KPE at Minia University Pediatric Surgery Unit between January 2021 and June 2024. All procedures included wide portal plate dissection and a 40cm Roux limb. Postoperative management involved high-dose steroids (5mg/kg/day with gradual tapering) and a six-month follow-up period.Results: The patients’ mean age was 74.97±21.8 days. Stool color normalization was observed in 74.5% of cases, whereas jaundice clearance was achieved in only 47.8% of patients. Jaundice clearance rates varied by age group: 71% in patients under 60 days, 52% in those aged 60–90 days, and 35% in patients older than 90 days.Conclusion: KPE remains a challenging procedure, and standardization is crucial. However, factors such as patient age which shows a significant effect on jaundice clearance in our study, associated anomalies, and liver condition significantly impact outcomes. Early detection is essential for improving success rates and can be facilitated by increasing awareness of biliary atresia among pediatricians and implementing screening programs.