Biliary atresia (BA) is an uncommon and progressive idiopathic biliary tract illness that can develop to end-stage liver disease. Kasai portoenterostomy is the primary therapy (KP). Adjuvant treatment following KP is intended to prevent cholangitis and minimize the need for liver transplantation (LT), however there is a paucity of data on its efficacy. Researchers looked at how substantial modifications in the post-KP procedure affected the overall results of BA. Between July 2012 and October 2018, the study enrolled 43 consecutive newborns receiving KP at Bambino Gesù Children’s Hospital. AT was compared to no therapy. At baseline and throughout the research, no significant variations in anthropometric or laboratory data were found between the two groups. The prevalence of clinical consequences of liver disease was comparable. The attainment of serum total bilirubin 1.5 mg/dL and acceptable Pediatric End-Stage Liver Disease scores six months after KP was not statistically different between the two groups. Cholangitis was observed in 30% of patients in the first 6 months postoperatively: 33% in the AT-free group and 28% in the AT group, respectively. Survival to LT listing at 12 months and without LT at 24 months did not differ substantially between the two groups.

AT after KP revealed contradictory outcomes; hence, multicentered, prospective, randomized control trials are required to better understand its value after KP, particularly in the multidrug resistance spread period.