Comparison of different Kasai portoenterostomy techniques in the outcomes of biliary atresia: a systematic review and network meta-analysis

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Key takeaways

• Robot-assisted KPE shows trend toward better jaundice clearance vs open/laparoscopic approaches, but differences are not statistically significant.
• Laparoscopic KPE has longer operative time but less intraoperative bleeding compared to open technique; hospital stay and complication rates similar.
• No significant differences in cholangitis incidence or liver survival rates at 6 months to 5 years across all three KPE techniques.
• Surgical technique selection should be individualized based on patient factors and cost, as success rates are comparable across approaches.
• Effective postoperative management is critical for preventing complications and slowing liver fibrosis; timely liver transplant needed when KPE fails.

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