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01-02-2021 | Liver Transplantation | Original Article

Effect of microscopy-assisted portoenterostomy (MAPE) for biliary atresia

Authors: Takehisa Ueno, Tasuku Kodama, Yuki Noguchi, Motonari Nomura, Ryuta Saka, Yuichi Takama, Yuko Tazuke, Kazuhiko Bessho, Hiroomi Okuyama

Published in: Pediatric Surgery International | Issue 2/2021

Abstract

Purpose

Portoenterostomy (PE) is the standard treatment for biliary atresia (BA). However, micro-bile ducts are difficult to identify with surgical loupes and dissect systematically. We report the effects of our attempts to dissect hilar tissue using a surgical microscope.

Methods

Microscopy-assisted portoenterostomy (MAPE) was initiated in 2014. Patients born between 2000 and 2013 who underwent PE until day 70 without a surgical microscope for BA were gathered as historical control. MAPE in re-do PE cases (Re-MAPE) was evaluated in the same manner.

Results

Ten patients underwent MAPE for BA during the study period. 17 patients in the conventional PE group were gathered. In the MAPE group, the jaundice clearance rate was 80%, compared with 53% in the conventional PE group. Re-MAPE was performed in four patients, who had a jaundice clearance rate of 75%, essentially identical to the rate with initial MAPE. At age 4 years, the native liver survival rate was 58% in the MAPE group and 38% in the conventional PE group. The native liver survival rate in the Re-MAPE group was 75%.

Conclusion

MAPE is useful for sharing the surgical field during open PE in patients with BA. It may improve the rate of jaundice clearance.

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Title: Effect of microscopy-assisted portoenterostomy (MAPE) for biliary atresia
Authors: Takehisa Ueno
Tasuku Kodama
Yuki Noguchi
Motonari Nomura
Ryuta Saka
Yuichi Takama
Yuko Tazuke
Kazuhiko Bessho
Hiroomi Okuyama
Publication date: 01-02-2021
Publisher: Springer Berlin Heidelberg
Keywords: Liver Transplantation
Liver Transplantation
Liver Transplantation
Liver Transplantation
Liver Transplantation
Published in: Pediatric Surgery International / Issue 2/2021
Print ISSN: 0179-0358
Electronic ISSN: 1437-9813
DOI: https://doi.org/10.1007/s00383-020-04794-x

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Effect of microscopy-assisted portoenterostomy (MAPE) for biliary atresia

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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