Effect of microscopy-assisted portoenterostomy (MAPE) for biliary atresia

Ueno, Takehisa; Kodama, Tasuku; Noguchi, Yuki; Nomura, Motonari; Saka, Ryuta; Takama, Yuichi; Tazuke, Yuko; Bessho, Kazuhiko; Okuyama, Hiroomi

doi:https://doi.org/10.1007/s00383-020-04794-x

Effect of microscopy-assisted portoenterostomy (MAPE) for biliary atresia

Ueno, Takehisa; Kodama, Tasuku; Noguchi, Yuki et al.

Pediatric Surgery International, 2021, 37(2), 223-228

Number of Access:1,093（2025-07-22 22:24 Counts）

Identifier to cite or link to this item: https://hdl.handle.net/11094/96429

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Title	Effect of microscopy-assisted portoenterostomy (MAPE) for biliary atresia
Creator	NRID 1000010456957 1000010456957 ORCID 0000-0002-4639-8814 0000-0002-4639-8814 researchmap permalink ueno-pedsurg ueno-pedsurg Scopus Author ID 21743992300 21743992300 CreatorName Ueno, Takehisa
	NRID 1000060771045 1000060771045 CreatorName Kodama, Tasuku
	NRID 1000030771042 1000030771042 CreatorName Noguchi, Yuki
	NRID 1000040546909 1000040546909 researchmap permalink moto_pedsurg moto_pedsurg Scopus Author ID 35208741700 35208741700 ORCID 0009-0004-0959-7461 0009-0004-0959-7461 CreatorName Nomura, Motonari
	NRID 1000000459190 1000000459190 ORCID 0000-0001-8960-8618 0000-0001-8960-8618 researchmap permalink sakaryuta sakaryuta CreatorName Saka, Ryuta
	NRID 1000050467560 1000050467560 CreatorName Takama, Yuichi
	NRID 1000010397698 1000010397698 researchmap permalink yukotazuke-osaka yukotazuke-osaka Scopus Author ID 7006109798 7006109798 ORCID 0000-0002-8335-0414 0000-0002-8335-0414 CreatorName Tazuke, Yuko
	NRID 1000080423169 1000080423169 CreatorName Bessho, Kazuhiko
	NRID 1000030252670 1000030252670 researchmap permalink okuyamahiroomi okuyamahiroomi Scopus Author ID 35496082300 35496082300 ORCID 0000-0002-1347-282X 0000-0002-1347-282X CreatorName Okuyama, Hiroomi
Subject	Jaundice clearance
	Liver transplantation
	Micro-bile duct
	Native liver survival
Description	This version of the article has been accepted for publication, after peer review (when applicable) and is subject to Springer Nature’s AM terms of use, but is not the Version of Record and does not reflect post-acceptance improvements, or any corrections. The Version of Record is available online at: https://doi.org/10.1007/s00383-020-04794-x.
Abstract	Purpose: Portoenterostomy (PE) is the standard treatment for biliary atresia (BA). However, micro-bile ducts are difficult to identify with surgical loupes and dissect systematically. We report the effects of our attempts to dissect hilar tissue using a surgical microscope. Methods: Microscopy-assisted portoenterostomy (MAPE) was initiated in 2014. Patients born between 2000 and 2013 who underwent PE until day 70 without a surgical microscope for BA were gathered as historical control. MAPE in re-do PE cases (Re-MAPE) was evaluated in the same manner. Results: Ten patients underwent MAPE for BA during the study period. 17 patients in the conventional PE group were gathered. In the MAPE group, the jaundice clearance rate was 80%, compared with 53% in the conventional PE group. Re-MAPE was performed in four patients, who had a jaundice clearance rate of 75%, essentially identical to the rate with initial MAPE. At age 4 years, the native liver survival rate was 58% in the MAPE group and 38% in the conventional PE group. The native liver survival rate in the Re-MAPE group was 75%. Conclusion: MAPE is useful for sharing the surgical field during open PE in patients with BA. It may improve the rate of jaundice clearance.
Publisher	Springer Science and Business Media Deutschland GmbH
Source Title	Pediatric Surgery International
Volume (Issue)	37(2)
Page	223-228
Date of Issued	2021-02-01
Language	English
Handle URL	https://hdl.handle.net/11094/96429
PISSN	01790358
eISSN	14379813
Relation.isVersionOf	DOI (Publisher Version) https://doi.org/10.1007/s00383-020-04794-x
Access Rights	open access
CopyRight	© 2021, Springer-Verlag GmbH Germany, part of Springer Nature.
oaire:version	Accepted Manuscript
Category	学術雑誌論文 Journal Article

Resource Type	journal article
Local Type	Journal Article
DCTERMS.bibliographicCitation	Pediatric Surgery International. 2021, 37(2), p. 223-228
DC.title	Effect of microscopy-assisted portoenterostomy (MAPE) for biliary atresia
DC.creator	Ueno, Takehisa
	Kodama, Tasuku
	Noguchi, Yuki
	Nomura, Motonari
	Saka, Ryuta
	Takama, Yuichi
	Tazuke, Yuko
	Bessho, Kazuhiko
	Okuyama, Hiroomi
DC.publisher	Springer Science and Business Media Deutschland GmbH
DC.language' scheme='DCTERMS.RFC1766	English
DCTERMS.issued' scheme='DCTERMS.W3CDTF	2021-02-01
DC.identifier	https://doi.org/10.1007/s00383-020-04794-x
DC.subject	Jaundice clearance
	Liver transplantation
	Micro-bile duct
	Native liver survival
DC.description	This version of the article has been accepted for publication, after peer review (when applicable) and is subject to Springer Nature’s AM terms of use, but is not the Version of Record and does not reflect post-acceptance improvements, or any corrections. The Version of Record is available online at: https://doi.org/10.1007/s00383-020-04794-x.
DCTERMS.abstract	Purpose: Portoenterostomy (PE) is the standard treatment for biliary atresia (BA). However, micro-bile ducts are difficult to identify with surgical loupes and dissect systematically. We report the effects of our attempts to dissect hilar tissue using a surgical microscope. Methods: Microscopy-assisted portoenterostomy (MAPE) was initiated in 2014. Patients born between 2000 and 2013 who underwent PE until day 70 without a surgical microscope for BA were gathered as historical control. MAPE in re-do PE cases (Re-MAPE) was evaluated in the same manner. Results: Ten patients underwent MAPE for BA during the study period. 17 patients in the conventional PE group were gathered. In the MAPE group, the jaundice clearance rate was 80%, compared with 53% in the conventional PE group. Re-MAPE was performed in four patients, who had a jaundice clearance rate of 75%, essentially identical to the rate with initial MAPE. At age 4 years, the native liver survival rate was 58% in the MAPE group and 38% in the conventional PE group. The native liver survival rate in the Re-MAPE group was 75%. Conclusion: MAPE is useful for sharing the surgical field during open PE in patients with BA. It may improve the rate of jaundice clearance.
DC.rights	© 2021, Springer-Verlag GmbH Germany, part of Springer Nature.
DC.format	96429
citation_title	Effect of microscopy-assisted portoenterostomy (MAPE) for biliary atresia
citation_author	Ueno, Takehisa
	Kodama, Tasuku
	Noguchi, Yuki
	Nomura, Motonari
	Saka, Ryuta
	Takama, Yuichi
	Tazuke, Yuko
	Bessho, Kazuhiko
	Okuyama, Hiroomi
citation_publisher	Springer Science and Business Media Deutschland GmbH
citation_language	English
citation_date	2021-02-01
citation_journal_title	Pediatric Surgery International
citation_volume	37
citation_issue	2
citation_firstpage	223
citation_lastpage	228
citation_doi	https://doi.org/10.1007/s00383-020-04794-x
citation_public_url	https://hdl.handle.net/11094/96429

Effect of microscopy-assisted portoenterostomy (MAPE) for biliary atresia

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