Wang Lei,Lan Zhaoping,Gao Qi,et al.Analysis of risk factors for cholangitis after Kasai procedure in biliary atresia children[J].Journal of Clinical Pediatric Surgery,,22():1039-1044.[doi:10.3760/cma.j.cn101785-202211061-007]
Analysis of risk factors for cholangitis after Kasai procedure in biliary atresia children
- Keywords:
- Biliary Atresia; Cholangitis; Root Cause Analysis; Surgical Procedures; Operative; Child
- Abstract:
- Objective To explore the risk factors of cholangitis after Kasai procedure for BA children.Methods Retrospective analysis of clinical data of 109 infants undergoing Kasai surgery for BA admitted to Xi’an Jiaotong University Affiliated Children’s Hospital from January 2018 to September 2020.Collect and record gender,operative age[＜60 d、60~90 d(60 d)、≥90 d],operating age,preoperative weight,cardiovascular malformations,Epstein-Barr virus infection,CMV infection,preoperative liver elastic modulus,preoperative liver function indexes[total bilirubin(TBIL), direct bilirubin(DBIL),Aspartate aminotransferase (AST),alanine aminotransferase (ALT),alkaline phosphatase (ALP),Glutamate transpeptidase (GGT),total bile acid (TBA),albumin (ALB),total cholesterol (TC)],operation duration,postoperative fasting time,postoperative hospital stay,postoperative hormone dosing,clearnace of jaundice within 6 months and occurrence of cholangitis.According to whether or not cholangitis occurred postoperatively,they were divided into two groups of cholangitis and non-cholangitis.Chi-square test or non-parametric test was utilized for univariate analysis and logistic regression for multivariate analysis.Results Among the 109 children,7(7/109,6.4%) cases had complete jaundice clearance within 1 month after operation,41(41/109,37.6%)cases had complete jaundice clearance within 3 months,and 53(53/109,48.6%) cases had complete jaundice clearance within 6 months; During the follow-up period,there were 71(71/109,65.1%)cases of cholangitis,51(51/109,46.8%) cases of cholangitis occurred within 3 months postoperatively,60(60/109,55.0%) cases of cholangitis occurred within 6 months postoperatively; 34(34/71,47.9%) cases of early cholangitis, 40(34/71,56.3%) cases of recurrent cholangitis.There was no statistically significant difference in liver function(TBIL、DBIL、ALT、AST、ALP、GGT、TBA、TC、ALB) between the two groups before operation(P＞0.05).There were no statistically significant differences between the cholangitis group and non-cholangitis group in male and female{[ 64.7%(33/51)vs.65.5%(38/58)]、[35.3%(18/51)vs.34.5%(20/58)]},preoperative weight[4.54(4.03 5.00)kg vs.4.50(3.90 4.54)kg ],cardiovascular malformation{[63.6%(42/66) vs.67.4%(29/43)]、[ 36.4%(24/66) vs.32.6%(14/43)]},elastic modulus of the right lobe of liver examined by preoperative color ultrasound[12.80(10.50~15.60)kPa vs.10.70(8.70~14.70)kPa],preoperative EBV infection{[62.7%(47/75) vs.75.0%(3/4)]、[37.3%(28/75) vs.25.0%(1/4)]},surgical duration[(3.42(2.92~3.70)h vs.3.24(2.90~3.75)h],postoperative fasting duration[3.00(3.00~3.29)d vs.3.00(3.00~4.00)d],postoperative hormone use or not{[ 54.8%(17/31) vs.69.2%(54/78)]、[ 45.2%(14/31) vs.30.8%(24/78)]},hospitalization duration [23.00(18.00~27.00)d vs.24.00(20.00~28.00)d],(P>0.05).The age of operation between the two groups was statistically significant [60%(39/65) vs.80.6%(29/36) vs.37.5%(3/8)?
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Memo
收稿日期:2022-11-29。
基金项目:西安市卫生健康委项目(2023ms09)
通讯作者:高琪,Email:851004877@qq.com