Pang Wenbo,Chen Yajun,Zhang Tingchong,et al.Diagnosis,management and prognosis of post-Kasai cholangitis[J].Journal of Clinical Pediatric Surgery,,21():41-45.[doi:10.3760/cma.j.cn.101785-202006073-008]
Diagnosis,management and prognosis of post-Kasai cholangitis
- Keywords:
- Biliary Atresia/SU; Cholangitis/DI; Cholangitis/TH; Prognosis
- Abstract:
- Objective To summarize the experience in the diagnosis and treatment of cholangitis after Kasai operation in children with biliary atresia, and analyze its longterm prognosis. Methods A retrospective study was performed on the clinical data of 66 cholangitis patients after Kasai operation from June 2008 to June 2017.The patients were categorized into Cefoperazone-Sulbactam group (n=17), Meropenem group (n=12) and Imipenem-Cilastatin Sodium group (n=37) according to the initial medication at the onset of primary cholangitis.and recurrence group (n=15) and non-recurrence group (n=51) based on the recurrence of cholangitis after treatment.The efficacy (primary cholangitis efficacy) and long-term prognosis (cure rate of cholangitis and 5-year survival rate of native liver) were compared between each group. Results The effective rates of the three initial medication groups were significantly different (41.2% vs.75.0% vs.89.2%;χ2=14.046, P=0.001), and Imipenem-Cilastatin Sodium group was obviously more effective than Cefoperazone-Sulbactam group (89.2% vs.41.2%;χ2=13.982, P<0.001).Compared with recurrence group, the non-recurrence group has higher cure rate of cholangitis in terms of long term prognosis (40.0% vs.88.2%;χ2=15.356, P<0.001)and native liver survival rate (82.8% vs.41.5%;χ2=7.993, P=0.005). Conclusion Early optimal management of post-Kasai cholangitis will help to maintain the native liver survival in the long term.Imipenem-Cilastatin Sodium can be the first choice of medication for recurrent post-Kasai cholangitis.Recurrence of cholangitis will expert adverse effects on patients’ prognosis.
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Memo
收稿日期:2020-06-29。
基金项目:中国工程院-外科扶持基金；北京市医院管理中心"青苗"计划专项经费资助（QML20191205）
通讯作者:陈亚军,Email:chenyajunmd@aliyun.com