Steroid use after the Kasai procedure for biliary atresia

Am J Surg. 2010 May;199(5):680-4. doi: 10.1016/j.amjsurg.2010.01.014.


Background: The aim of this study was to describe patients undergoing the Kasai procedure at children's hospitals, evaluate outcomes, and analyze the association of these outcomes with systemic steroid use.

Methods: Biliary atresia patients (International Classification of Diseases, Ninth Revision, code 751.61) who underwent Kasai procedures at freestanding children's hospitals in the Pediatric Health Information System database from 2003 to 2008 were identified. Descriptive characteristics were examined, and regression analyses were used to determine whether postoperative steroid use was associated with length of stay, mortality, or cholangitis.

Results: Of the 516 children identified (40% male, 50% aged < 2 months), 239 (46%) received perioperative steroids. The mean total and postoperative lengths of stay were 14.5 +/- 19.7 and 11.3 +/- 16.3 days, respectively. Postoperative steroid use was significantly associated with a 3.5-day decrease in postoperative length of stay (95% confidence interval, .03-6.97).

Conclusions: Perioperative steroids after the Kasai procedure are associated with shorter postoperative length of stay. Work is needed to ascertain whether this relationship is causal.

MeSH terms

  • Biliary Atresia / diagnosis
  • Biliary Atresia / drug therapy*
  • Biliary Atresia / mortality
  • Biliary Atresia / surgery*
  • Cohort Studies
  • Confidence Intervals
  • Databases, Factual
  • Dose-Response Relationship, Drug
  • Drug Administration Schedule
  • Female
  • Follow-Up Studies
  • Hospital Mortality / trends
  • Hospitals, Pediatric
  • Humans
  • Infant
  • Infant, Newborn
  • Length of Stay
  • Male
  • Portoenterostomy, Hepatic / adverse effects
  • Portoenterostomy, Hepatic / methods*
  • Postoperative Care / methods
  • Probability
  • Retrospective Studies
  • Risk Assessment
  • Severity of Illness Index
  • Steroids / therapeutic use*
  • Survival Rate
  • Time Factors
  • Treatment Outcome


  • Steroids