Abstract
Introduction Hepatoportoenterostomy (HPE) is the first-line treatment for biliary atresia (BA)
patients. This study aims to describe perioperative complications after HPE and to
analyze their impact on outcome.
Materials and Methods Patients with HPE (Swiss National Biliary Atresia Registry, 1994–2017) were retrospectively
analyzed. Perioperative complications were defined as complications occurring up to
30 days after surgery. Surgical complications were defined as directly related to
the surgical act; medical complications were defined as any other deviation from the
uneventful postoperative course.
Results Sixty-two patients were included. Median age at HPE was 63 days (18–126). Twenty
six patients out of 62 (42%) had ≥ 1 complications: 6/62 (10%) surgical, 24/62 (39%)
medical, that is, we observed 7 surgical and 28 medical complications. As for medical
complications, cholangitis was the most frequent: 19/28 (68%). Lower gestational age
at birth correlated with more overall complications (p = 0.02). Age, weight at HPE, syndromic BA, and postoperative steroid administration
were not significantly correlated. There were no perioperative deaths. Perioperative
complications did not correlate with overall survival (p = 0.14) and survival with native liver (p = 0.55).
Conclusion HPE is often associated with perioperative medical complications. Lower gestational
age at birth was significantly associated with more complications. Perioperative complications
had no impact on overall outcome.
Keywords
hepatoportoenterostomy - biliary atresia - complications
