Biliary atresia in Vietnam: Management and the burden of disease
| Autor: | Hoa Pham Anh Nguyen, Max Liu, Thuy Bui Huong, Ai Xuan Holterman, Hai Thanh Le, Shauna Trinh, Xuyen Hoang, Lan Doan |
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| Rok vydání: | 2016 |
| Předmět: |
Burden of disease
Male medicine.medical_specialty Time Factors Portoenterostomy Hepatic Risk Assessment Cohort Studies 03 medical and health sciences Liver disease 0302 clinical medicine Postoperative Complications Biliary atresia Biliary Atresia 030225 pediatrics medicine Humans Hospital Mortality Developing Countries Survival analysis Retrospective Studies Kasai procedure business.industry Clinical course Infant Newborn Infant Retrospective cohort study medicine.disease Hospitals Pediatric Prognosis Survival Analysis Surgery Treatment Outcome Vietnam 030211 gastroenterology & hepatology Female business Needs Assessment Cohort study |
| Zdroj: | Surgery. 161(2) |
| ISSN: | 1532-7361 |
| Popis: | Biliary atresia is an idiopathic, neonatal liver disease of the bile ducts. The natural evolution of biliary atresia is known in developed countries. This study describes the clinical course of biliary atresia in Vietnam, a developing country.Chart reviews were undertaken of patients treated with or without the Kasai procedure between January 2010 and July 2013 at a children's hospital in Vietnam.Of 287 children with biliary atresia, 149 (52%) were treated without the Kasai procedure and 138 (48%) were treated with the Kasai procedure. Median age at diagnosis was 2.4 months for children treated without the Kasai procedure vs 2.3 months for those treated with the procedure. The percentages of patients in the group treated without the Kasai procedure presenting at2 months, 2 to3 months, 3 to4 months, 4-6 months, and6 months of age were 31%, 35%, 15%, 10%, and 9%, respectively, compared to those treated with the Kasai procedure at 36% (P = .38), 44% (P = .12), 16% (P = 1.0), 4% (P = .037), and 0% (P .001), respectively. The group treated without the Kasai procedure had 1- and 2-year survivals of 52% and 28%, respectively (median survival 6.6 months); in contrast, the group treated with the Kasai procedure had 1- and 2-year transplant-free survivals of 84% and 71%. No patients were treated by liver transplantation because of lack of a liver transplantation program in Vietnam.The majority of biliary atresia in Vietnam remains untreated despite early presentation and reasonable outcomes after a Kasai procedure relative to Western countries. These data illustrate the high health care burden for biliary atresia in Vietnam and the need to improve education about biliary atresia and its treatment. |
| Databáze: | OpenAIRE |
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