Does adjuvant steroid therapy post-Kasai portoenterostomy improve the outcome of biliary atresia? A systematic review and meta-analysis

摘要: BACKGRounD: The role of adjuvant steroid therapy in the postop- erative management patients with biliary atresia (BA) is unclear. oBJeCtive: To systematically review literature and perform a meta-analysis to determine efficacy post-Kasai portoenterostomy (KP) on BA outcome. MethoDS: A systematic randomized trials and/or observational studies that examined steroids outcomes published between January 1969 June 2010 was conducted. Studies were identified using Medline, PubMed, EMBASE Cochrane databases. ReSultS: Sixteen one con- trolled trial (RCT) found. Four 16 (160 participants) RCT (73 met entry crite- ria eligible be included analysis. There no statisti- cally significant difference effect either normalizing serum bilirubin levels at six months (pooled OR 1.48 (95% CI 0.67 3.28)) or delaying need for early liver transplantation (within first year post-KP 0.59 0.21 1.72)). ConCluSion: present did not find over standard therapy, post-KP. sufficient size compre- hensive design high-dose are needed effectiveness short intermediate out- comes patients. une steroidotherapie adjuvante apres porto- enterostomie de Kasai ameliore-t-elle l'issue l'atresie biliaire? analyse systematique et meta-analyse