{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T20:02:25Z","timestamp":1791403345036,"version":"4.3.3"},"reference-count":30,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T00:00:00Z","timestamp":1747180800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To evaluate the early efficacy and safety of partial quadrate lobectomy during laparoscopic Kasai surgery for type III biliary atresia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This retrospective study included 25 children diagnosed with type III biliary atresia, who underwent laparoscopic Kasai surgery between February 2018 and July 2022. Patients were divided into two groups: one with partial quadrate lobectomy and the other without. Data collected included age, gender, weight, incidence of cholangitis before and after surgery, one-year native liver survival, intraoperative blood loss, surgery duration, and jaundice clearance at 6 and 12 months. Follow-up results were compared between the groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The partial quadrate lobectomy group (14 patients) had a mean weight of 5.50\u2005kg and average age of 66.79 days, while the control group (11 patients) had a similar weight (5.50\u2005kg) and a mean age of 71.09 days. Weight comparison showed no significant difference (5.50\u2005kg vs. 5.50\u2005kg, <jats:italic>P<\/jats:italic>\u2009=\u20090.427). One-year postoperative native liver survival was 9\/14 in the partial quadrate lobectomy group vs. 6\/11 in the control group (<jats:italic>P<\/jats:italic>\u2009=\u20090.654).Intraoperative blood loss was similar between groups (<jats:italic>P<\/jats:italic>\u2009&amp;gt;\u20090.05), but the shorter operative time (301 vs. 347\u2005min) associated with partial quadrate lobe resection may reduce anesthesia-related risks in infants, particularly given their limited physiological reserve. The reduced cholangitis rate (29% vs. 73%) aligns with prior reports suggesting that improved hilar exposure facilitates more precise dissection of fibrotic remnants, potentially minimizing postoperative bile stasis and infection. Jaundice clearance (defined as TBIL &amp;lt;20\u2005\u03bcmol\/L) was achieved in 8\/14 (57.1%) of the partial quadrate lobectomy group vs. 3\/11 (27.3%) in the control group at 6 months (<jats:italic>P<\/jats:italic>\u2009=\u20090.025), and 10\/14 (71.4%) vs. 4\/11 (36.4%) at 12 months (<jats:italic>P<\/jats:italic>\u2009=\u20090.031). The lower TBIL levels (5.11 vs. 9.67\u2005mg\/dl) at 6 months suggest enhanced bile drainage efficacy, which is critical for delaying or avoiding liver transplantation in this population.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Partial quadrate lobectomy during laparoscopic Kasai surgery reduces operation time, lowers cholangitis incidence, and improves jaundice clearance rates without increasing intraoperative blood loss or adversely affecting one-year native liver survival. It is a safe and feasible adjunct to improve early postoperative outcomes.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fped.2025.1541455","type":"journal-article","created":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T05:39:53Z","timestamp":1747201193000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Partial quadrate lobectomy improves early outcomes of laparoscopic Kasai surgery in type III biliary 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