{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,12]],"date-time":"2025-12-12T13:24:28Z","timestamp":1765545868816},"reference-count":16,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2014,2,15]],"date-time":"2014-02-15T00:00:00Z","timestamp":1392422400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ANZ Journal of Surgery"],"published-print":{"date-parts":[[2015,11]]},"abstract":"Abstract<\/jats:title>Background<\/jats:title>Recent follow\u2010up studies have demonstrated significant improvement in overall survival as well as survival with native liver following geographic centralization of services to three centres in the UK<\/jats:styled-content>. However, this model has not been replicated in countries with relatively low population density such as A<\/jats:styled-content>ustralia and C<\/jats:styled-content>anada.<\/jats:p><\/jats:sec>Methods<\/jats:title>Retrospective evaluation of all patients born with biliary atresia (BA<\/jats:styled-content>) in S<\/jats:styled-content>outh A<\/jats:styled-content>ustralia from 1989 to 2010 was performed. Thirty\u2010one patients with BA<\/jats:styled-content> were discovered. Two patients were excluded because the initial Kasai procedure (KP<\/jats:styled-content>) was performed interstate. Outcome parameters measured were (i) clearance of jaundice (bilirubin of less than 20\u2009\u03bcmol\/L, by 6 months); (ii) survival with native liver; and (iii) overall survival. K<\/jats:styled-content>aplan\u2013M<\/jats:styled-content>eier survival curves were plotted for both survival with native liver and overall survival.<\/jats:p><\/jats:sec>Results<\/jats:title>The incidence of BA<\/jats:styled-content> in S<\/jats:styled-content>outh A<\/jats:styled-content>ustralia between 1989 and 2010 was 7.48 per 100\u2009000 live births. Following KP<\/jats:styled-content>, clearance of jaundice was achieved in 42.9% of patients. Five\u2010year actuarial survival with native liver was 55.2%, and overall 5\u2010year actuarial survival was 89.3%.<\/jats:p><\/jats:sec>Conclusions<\/jats:title>The results of KP<\/jats:styled-content> performed at Women's and Children's Hospital from 1989 to 2010 can be considered comparable with international benchmarks. Based on these results, we propose the creation of a \u2018centralized\u2019 pool of surgeons in A<\/jats:styled-content>ustralia to help continue providing \u2018decentralized\u2019 care of BA<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ans.12522","type":"journal-article","created":{"date-parts":[[2014,2,17]],"date-time":"2014-02-17T11:01:44Z","timestamp":1392634904000},"page":"865-868","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Kasai hepatoportoenterostomy in S<\/scp>outh A<\/scp>ustralia: a case for \u2018centralized decentralization\u2019"],"prefix":"10.1111","volume":"85","author":[{"given":"Chen Gang","family":"Tu","sequence":"first","affiliation":[{"name":"Orthopaedic Department Modbury Hospital Adelaide South Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sanjeev","family":"Khurana","sequence":"additional","affiliation":[{"name":"Department of Paediatric Surgery Women's and Children's Hospital Adelaide South Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard","family":"Couper","sequence":"additional","affiliation":[{"name":"Department of Paediatric Surgery Women's and Children's Hospital Adelaide South Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew W. 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