LIU Gang,GAO Xin,LIU Shu-li,et al.The managements and prognosis of intrahepatic biliary dilatation with biliary atresia after Kasai procedure[J].Journal of Clinical Pediatric Surgery,2010,9(03):0.
胆道闭锁葛西手术后肝内胆管扩张的治疗与预后分析
- Title:
- The managements and prognosis of intrahepatic biliary dilatation with biliary atresia after Kasai procedure
- Keywords:
- Postoperative Complications; Biliary Atresia/SU; Bile Dile Ducts; Intrahepatic; Therapy; Prognosis
- 摘要:
- 目的 探讨胆道闭锁葛西手术后肝内胆管扩张（Intrahepatic biliary cysts, IBCs）的治疗选择和预后情况。方法 回顾性分析8例肝内胆管囊性扩张患儿的临床表现、治疗过程和转归，其中2例单发囊肿型胆管扩张患儿分别予手术和抗感染治疗；6例多发复杂囊肿型胆管扩张患儿均行经皮肝胆管引流术（PTCD）治疗。 结果 2例单发囊肿型胆管扩张患儿疗效好，预后良好。6例多发复杂囊肿型胆管扩张患儿经PTCD引流后，2例再次开腹手术吻合；6例患儿中，3例死亡，1例行肝脏移植，1例等待肝移植，1例合并门静脉高压存活。 结论 胆道闭锁葛西术后多发肝内胆管扩张（C型）常提示存在严重肝脏损伤， PTCD治疗或手术再吻合治疗多数情况下仅是姑息治疗。PTCD有助于减轻黄疸，改善肝移植术前条件；而无条件进行肝脏移植的患者，单纯PTCD很难长期控制临床症状，应选择再次手术行扩张胆管肠吻合手术。单发肝内胆管扩张（A型）临床过程和预后明显优于C型扩张，可能与肝脏受损程度较轻有关。
- Abstract:
- Abjective To investigate the managements and prognosis of biliary atresia children with intrahepatic biliary cysts after Kasai procedure. Methods 8 cases of intrahepatic biliary cysts were reviewed about the clinic features, therapy and prognosis. Among
参考文献/References:
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备注/Memo
作者单位：上海交通大学医学院附属新华医院儿外科（200092）