胆道闭锁Kasai手术后未发生胆管炎患儿的近中期疗效及影响因素分析OA北大核心

Objective To explore the short/medium-term efficacies and influencing factors after Kasai surgery in children with biliary atresia(BA)without cholangitis.Methods From November 2016 to October 2022,the clinical data were retrospectively reviewed for 70 type Ⅲ BA children without cholangitis after Kasai surgery.According to early bile drainage status,they were assigned into two groups of early bile drainage-good(EBD-G,n=25)and early bile drainage-poor(EBD-P,n=45).Two groups were compared with regards to general profiles,preoperative liver function parameters,degree of hepatic fibrosis and postoperative rate of native liver survival(NLS).Results There were 31 boys and 39 girls.NLS rates at Month 6 and Year 1/3/5 post-operation were 68.6％,51.4％,48.3％and 48.3％.NLS rates at Month 6 and Year 1/3/5 post-operation were 100％,95.8％,95.8％,95.8％and 51.1％,26.7％,22.2％,22.2％in EBD-G and EBD-P groups.NLS rate of EBD-G group was higher than that of EBD-P group with statistically significant differences(P＜0.001).In EBD-P group,day age during Kasai surgery[(69.60±14.82)vs.(61.84±14.96)day],body weight[(4.95±0.69)vs.(4.57±0.66)kg]and preoperative aspartate aminotransferase(AST)[(246.27±101.04)vs.(178.20±64.45)U/L]were higher than those within EBD-G group and the difference was statistically sig-nificant(P＜0.05).Preoperative level of γ-glutamyl transferase(GGT)was higher in EBD-G group than that in EBD-P group[654.00(391.00,803.00)vs.340.00(160.00,460.00)U/L]and there was statistically sig-nificant difference(P＜0.05).Conclusions Early bile drainage is an important factor affecting NLS in chil-dren without cholangitis after Kasai surgery.Operative age,body weight and preoperative levels of AST and GGT are correlated with early bile drainage.