Shen Qiulong,Chen Yajun,Peng Chunhui,et al.Predicting five-year native liver survival after Kasai procedure of biliary atresia by liver stiffness measurement[J].Journal of Clinical Pediatric Surgery,,19():486-490,512.[doi:10.3969/j.issn.1671-6353.2020.06.005]
Predicting five-year native liver survival after Kasai procedure of biliary atresia by liver stiffness measurement
- Keywords:
- Biliary Atresia; Transplantation; Autologous; Liver Transplantation; Ultrasonography; Liver/AH; Forecasting
- CLC:
- R575.7;R725.7;R364.3+2
- Abstract:
- Objective To explore the value of liver stiffness measurement(LSM)in predicting five-year native liver survival after Kasai procedure in children with biliary atresia(BA).Methods From April 2012 to February 2013,31 cases of BA undergoing Kasai operation were analyzed retrospectively.There were 11 boys and 20 girls.The LSM and liver function were collected before operation and at 2/4/8 weeks after operation.Liver fibrosis was graded according to liver pathology during operation.The endpoints of follow-up were death,liver transplantation or five-year native liver survival.They were divided into two groups based upon five-year native liver survival.Results There were 16 cases in native liver survival group(8 boys,8 girls)and 15 cases in non-native liver survival group(3 boys,12 girls).No significant inter-group differences existed in operative age,liver fibrosis grade,LSM before operation or 2 weeks after operation.The difference of LSM at 4 and 8 weeks after operation was statistically significant,(11.3±4.3)vs(19.6±9.7)kPa and(14.6±7.7)vs(38.2±22.3)kPa,respectively.According to ROC curve analysis,the LSM cutoff values for predicting five-year native liver survival were 13.2 kPa(4 weeks after operation)with AUC=0.871,sensitivity=81.8%,specificity=75.0% and 21.6kPa(8 weeks after operation)with AUC=0.898,sensitivity=81.8%,specificity=91.7%,respectively.Conclusion LSM may be employed for predicting five-year native liver survival of BA children after Kasai operation.LSM>13.2 kPa at 4 weeks and 21.6 kPa at 8 weeks after operation indicate that the possibility of five-year native liver survival decreases.
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Memo
收稿日期:2020-02-10。
基金项目:中国工程院-外科扶持基金
通讯作者:陈亚军,Email:chenyajunmd@aliyun.com