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Peer-reviewedCC BYPediatric surgery international

Nationwide outcomes of biliary atresia after Kasai portoenterostomy in Taiwan: the impact of postoperative cholangitis and corticosteroid use.

  • Hsiao-Hui Yang1,2,3
  • Wan Ting Huang4
  • Jen-Hung Wang4
  • Ming-Chun Chen5,6
  • Shu-Hui Wen7,8
8 affiliations
  1. 1Division of Pediatric Surgery, Department of Surgery, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan.
  2. 2School of Medicine, Tzu Chi University, Hualien, Taiwan.
  3. 3Institute of Medical Sciences, Tzu Chi University, Hualien, Taiwan.
  4. 4Epidemiology and Biostatistics Center, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, 97004, Taiwan.
  5. 5School of Medicine, Tzu Chi University, Hualien, Taiwan. [email protected].
  6. 6Department of Pediatrics, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, No. 707, Zhongyang Rd., Sec. 3, Hualien, 97004, Taiwan. [email protected].
  7. 7Institute of Medical Sciences, Tzu Chi University, Hualien, Taiwan. [email protected].
  8. 8Department of Public Health, College of Medicine, Tzu-Chi University, No. 701, Zhongyang Rd., Sec. 3, Hualien, 97004, Taiwan. [email protected].
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Abstract

Purpose

To provide updated nationwide outcomes of biliary atresia (BA) among patients in Taiwan, focusing on postoperative cholangitis, liver transplantation (LT), corticosteroid use, and renal outcomes.Methods

Infants with BA who underwent Kasai portoenterostomy were identified from the Taiwan National Health Insurance Research Database (2008-2019). Postoperative outcomes were evaluated, and the association between cholangitis episodes and LT was analyzed using exploratory logistic regression analysis. Corticosteroid exposure was categorized by duration, and acute kidney injury was assessed as a secondary outcome.Results

This study included 334 infants. Acute cholangitis occurred in 76.3% of cases, with 24.9% experiencing ≥ 5 hospitalizations. A greater number of cholangitis episodes was associated with a higher likelihood of LT (odds ratio: 1.08, 95% confidence interval: 1.00-1.16, p = 0.044). Approximately 30.8% of patients developed biliary cirrhosis, and 33.8% received LT. Corticosteroids were prescribed to 96% of patients, and a longer treatment duration was associated with higher complication rates. About 1.8% of patients developed acute kidney injury, with no progression to end-stage renal disease.Conclusion

Postoperative cholangitis remains an important clinical factor associated with LT in infants with BA. Corticosteroid treatment duration may reflect underlying disease severity rather than therapeutic benefit. Renal complications are uncommon. Optimizing postoperative care-particularly timely cholangitis management-is essential to improve outcomes.

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Cite

BibTeXRIS
BibTeX
@article{yang2026nationwide,
  title = {{Nationwide outcomes of biliary atresia after Kasai portoenterostomy in Taiwan: the impact of postoperative cholangitis and corticosteroid use.}},
  author = {Hsiao-Hui Yang and Wan Ting Huang and Jen-Hung Wang and Ming-Chun Chen and Shu-Hui Wen},
  journal = {Pediatric surgery international},
  year = {2026},
  month = oct,
  doi = {10.1007/s00383-026-06689-9},
  url = {https://europepmc.org/article/MED/42900357},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Nationwide outcomes of biliary atresia after Kasai portoenterostomy in Taiwan: the impact of postoperative cholangitis and corticosteroid use.
AU  - Hsiao-Hui Yang
AU  - Wan Ting Huang
AU  - Jen-Hung Wang
AU  - Ming-Chun Chen
AU  - Shu-Hui Wen
PY  - 2026
DA  - 2026/10/20
JO  - Pediatric surgery international
DO  - 10.1007/s00383-026-06689-9
UR  - https://europepmc.org/article/MED/42900357
AB  - Purpose  To provide updated nationwide outcomes of biliary atresia (BA) among patients in Taiwan, focusing on postoperative cholangitis, liver transplantation (LT), corticosteroid use, and renal outcomes.Methods  Infants with BA who underwent Kasai portoenterostomy were identified from the Taiwan National Health Insurance Research Database (2008-2019). Postoperative outcomes were evaluated, and the association between cholangitis episodes and LT was analyzed using exploratory logistic regression analysis. Corticosteroid exposure was categorized by duration, and acute kidney injury was assessed as a secondary outcome.Results  This study included 334 infants. Acute cholangitis occurred in 76.3% of cases, with 24.9% experiencing ≥ 5 hospitalizations. A greater number of cholangitis episodes was associated with a higher likelihood of LT (odds ratio: 1.08, 95% confidence interval: 1.00-1.16, p = 0.044). Approximately 30.8% of patients developed biliary cirrhosis, and 33.8% received LT. Corticosteroids were prescribed to 96% of patients, and a longer treatment duration was associated with higher complication rates. About 1.8% of patients developed acute kidney injury, with no progression to end-stage renal disease.Conclusion  Postoperative cholangitis remains an important clinical factor associated with LT in infants with BA. Corticosteroid treatment duration may reflect underlying disease severity rather than therapeutic benefit. Renal complications are uncommon. Optimizing postoperative care-particularly timely cholangitis management-is essential to improve outcomes.
SN  - 0179-0358
SN  - 1437-9813
ER  -