Li Sijin,Zeng Jixiao,Xu Xiaogang,et al.Analysis of short/medium-term effectiveness and influencing factors after Kasai surgery in patients with biliary atresia without cholangitis[J].Journal of Clinical Pediatric Surgery,,():30-34.[doi:10.3760/cma.j.cn101785-202405016-006]
Analysis of short/medium-term effectiveness and influencing factors after Kasai surgery in patients with biliary atresia without cholangitis
- Keywords:
- Biliary Atresia; Surgical Procedures; Operative; Postoperative Complications; Cholangitis; Treatment Outcome; Root Cause Analysis
- Abstract:
- Objective To explore the short/medium-term efficacies and influencing factors after Kasai surgery in children with biliary atresia (BA) without cholangitis. Methods From November 2016 to October 2022,the clinical data were retrospectively reviewed for 70 type Ⅲ BA children without cholangitis after Kasai surgery.According to early bile drainage status,they were assigned into two groups of early bile drainage-good (EBD-G,n=25) and early bile drainage-poor (EBD-P,n=45).Two groups were compared with regards to general profiles,preoperative liver function parameters,degree of hepatic fibrosis and postoperative rate of native liver survival (NLS). Results There were 31 boys and 39 girls.NLS rates at Month 6 and Year 1/3/5 post-operation were 68.6%,51.4%,48.3% and 48.3%.NLS rates at Month 6 and Year 1/3/5 post-operation were 100%,95.8%,95.8%,95.8% and 51.1%,26.7%,22.2%,22.2% in EBD-G and EBD-P groups.NLS rate of EBD-G group was higher than that of EBD-P group with statistically significant differences (P<0.001).In EBD-P group,day age during Kasai surgery, body weight and preoperative aspartate aminotransferase (AST) [(246.27±101.04) vs.(178.20±64.45) U/L]were higher than those within EBD-G group and the difference was statistically significant (P<0.05).Preoperative level of γ-glutamyl transferase (GGT) was higher in EBD-G group than that in EBD-P group and there was statistically significant difference (P<0.05). Conclusions Early bile drainage is an important factor affecting NLS in children without cholangitis after Kasai surgery.Operative age,body weight and preoperative levels of AST and GGT are correlated with early bile drainage.
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Memo
收稿日期:2024-5-7。
基金项目:国家自然科学基金(82170528);广东省自然科学基金(2022A1515012254);广州市科技计划市校(院)联合资助项目(202201020612);广州地区临床特色技术项目(2023C-TS48);广州市科技计划市校(院)企联合资助项目(2024A03J1236)
通讯作者:刘斐,Email:star5044207@163.com