Abstract | AIM: The aim of this systematic review and meta-analysis was to determine if adjunct steroids affect jaundice-free, cholangitis, and survival rates after Kasai portoenterostomy. METHODS: RESULTS: Ten studies were included in the systematic review and 8 in the meta-analyses. Steroid treatment regimens were inconsistent between studies. The pooled odds ratio (OR) for the jaundice-free rate did not significantly favor steroid over non- steroid treatment (1.95; 95% confidence interval [CI]: 0.91-4.11; P = 0.087), nor did the pooled OR for the cholangitis rate (0.75; 95% CI: 0.48-1.17; P = 0.202). Overall survival ranged from 58 to 95% in the steroid group and from 36 to 96% in the control group. Native liver survival ranged from 30 to 56% in the steroid group and from 31 to 48% in the control group. The survival data were not suitable for meta-analysis. CONCLUSIONS: Although these results imply that adjunct steroids after Kasai portoenterostomy for BA may not improve jaundice-free or cholangitis rates, the quality of available evidence is limited and therefore not definitive. Additional high quality studies are needed.
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Authors | Da Zhang, He-ying Yang, Jia Jia, Ge Zhao, Ming Yue, Jia-xiang Wang |
Journal | International journal of surgery (London, England)
(Int J Surg)
Vol. 12
Issue 11
Pg. 1203-9
(Nov 2014)
ISSN: 1743-9159 [Electronic] England |
PMID | 25224699
(Publication Type: Journal Article, Meta-Analysis, Review, Systematic Review)
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Copyright | Copyright © 2014 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved. |
Chemical References |
- Glucocorticoids
- Dexamethasone
- Prednisolone
- Hydrocortisone
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Topics |
- Biliary Atresia
(complications, mortality, surgery)
- Cholangitis
(epidemiology, prevention & control)
- Dexamethasone
(therapeutic use)
- Glucocorticoids
(therapeutic use)
- Humans
- Hydrocortisone
(therapeutic use)
- Jaundice
(epidemiology, prevention & control)
- Portoenterostomy, Hepatic
- Postoperative Care
- Prednisolone
(therapeutic use)
- Survival Rate
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