Jin Yuyan,Liu Zhaozhou,Zhao Jiawei,et al.Curative effect of Kasai operation for neonatal biliary atresia[J].Journal of Clinical Pediatric Surgery,2024,(08):716-722.[doi:10.3760/cma.j.cn101785-202402001-004]
新生儿期Kasai手术治疗胆道闭锁疗效观察
- Title:
- Curative effect of Kasai operation for neonatal biliary atresia
- Keywords:
- Biliary Atresia; Surgical Procedures; Operative; Treatment Outcome; Postoperative Complications; Infant; Newborn
- 摘要:
- 目的 分析新生儿期接受Kasai手术的胆道闭锁患儿围手术期情况及预后,探讨新生儿期Kasai手术治疗胆道闭锁的疗效。 方法 回顾性分析2018年1月至2022年8月就诊于首都医科大学附属北京儿童医院的52例胆道闭锁患儿临床资料,其中男婴24例、女婴28例,入院年龄32.5(6.0,57.0)d,手术年龄37.0(12.0,58.0) d,术前体重(3 992.6±685.1)g。按手术年龄分为两组,其中新生儿期手术12例(23.1%),为新生儿组;非新生儿期手术40例,为非新生儿组。对比两组Kasai手术情况、术后黄疸清除情况及自体肝生存情况等,总结新生儿期Kasai手术治疗胆道闭锁的效果。 结果 52例均接受开腹Kasai手术,术后住院时长15.0(14.0,19.5)d,随访时长37.5(14~66)个月。新生儿组Kasai术后6个月黄疸清除率高于非新生儿组(8/12比17/29),Kasai术后1年自体肝生存率也高于非新生儿组(66.7%比63.2%)。 结论 新生儿期Kasai手术安全有效,当新生儿期疑诊为胆道闭锁时应尽早手术探查、明确诊断,并行Kasai手术治疗。
- Abstract:
- Objective To compare the clinical efficacy of Kasai procedure for biliary atresia (BA) between neonatal and non-neonatal periods.Methods From January 2018 to August 2022,the relevant clinical data were retrospectively reviewed for 52 hospitalized BA children.There were 24 boys (46.2%) and 28 girls (53.8%).Median age at admission was 32.5(6.0,57.0) day,median age at surgery 37.0(12.0,58.0) day and mean preoperative body weight (3992.6±685.1) gram.The clinical efficacy of Kasai procedure for BA in neonatal period was analyzed by comparing operative findings,postoperative jaundice clearance and survival of autologous liver.Results All of them underwent Kasai procedure.Median postoperative hospitalization stay was 15.0 day and median follow-up period 37.5(14-66) month.At Month 6 post-Kasai,clearance rate of jaundice was higher in neonatal group than that in non-neonatal group (66.7% vs.58.6%).And 1-year native liver survival rate after Kasai operation was higher in neonatal group than that in non-neonatal group (66.7% vs.63.2%).Conclusions Kasai procedure during neonatal period is both safe and effective.When BA is suspected in neonatal period,surgical exploration should be performed as soon as possible to confirm the diagnosis and perform Kasai procedure.
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备注/Memo
收稿日期:2024-2-1。
通讯作者:黄金狮,Email:jsdr2002@126.com