Xie Zhenyu,Pu Siyu,Zhang Yimao,et al.Analysis of the efficacy of Kasai surgery for biliary atresia and analysis of the related factors of postoperative jaundice clearance[J].Journal of Clinical Pediatric Surgery,2025,(02):152-158.[doi:10.3760/cma.j.cn101785-202410047-009]
Analysis of the efficacy of Kasai surgery for biliary atresia and analysis of the related factors of postoperative jaundice clearance
- Keywords:
- Biliary Atresia; Surgical Procedures; Operative; Kasai Procedure; Treatment Outcome; Postoperative Complications
- Abstract:
- Objective To summarize the effect of Kasai procedure of biliary atresia (BA) and explore the relevant factors affecting the clearance of postoperative jaundice. Methods The relevant clinical data were retrospectively reviewed for 340 BA children admitted from September 2015 to August 2022.There were 160 boys and 180 girls with an average age of (47.47±11.61) day.The procedures were Kasai (n=227),open surgery (n=124) and laparoscopy (n=103).Demographic profiles,surgical findings,clinical parameters and pathological examinations were recorded for examining the factors affecting the clearance of jaundice after Kasai surgery for BA. Results The final clearance of jaundice in our group of children was 65.20%(146/227) and the cumulative survival rate of native liver at 5 years after Kasai procedure 35.20%.Age (P=0.025),ultrasonic thickness of hepatic hilar fibrous tissue (P=0.016),frequency of cholangitis episodes within 6-month postoperative period (P=0.035) and hepatic elasticity value (P=0.029) had a significant impact on jaundice clearance rate after Kasai’s procedure.Multifactorial Logistic regression analysis of the influencing factors at P<0.05 showed that age,ultrasonic thickness of fibrous tissue in hepatic portal,number of small bile ducts ≥150 μm in diameter per unit cross-sectional area of fibrous tissue in hepatic hilar region and frequency of cholangitis episodes within 6-month postoperative period were the independent risk factors for the clearance of postoperative jaundice after Kasai procedure. Conclusions The overall outcome of jaundice clearance after Kasai procedure for BA is efficacious and it may prolong native liver survival.
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Memo
收稿日期:2024-10-19。
基金项目:国家自然科学基金(81571473)
通讯作者:靳曙光,Email:shgjin2003@aliyun.com