Department of Paediatric Gastroenterology abd Nutrition, Royal Hospital for Sick Children, Glasgow G3 8SJ, UK.
Arch Dis Child. 2013 May;98(5):381-3. doi: 10.1136/archdischild-2011-301608. Epub 2013 Feb 21.
To evaluate the outcome of Scottish children with extra hepatic biliary atresia (EHBA) since rationalisation of Kasai services to three English centres in 2002 (The 'Group A' centres).
All Scottish children with EHBA diagnosed between 2002 and 2009 were identified via the Scottish Society of Paediatric Gastroenterology, Hepatology and Nutrition (SSPGHAN) clinicians. A case-note review was conducted with demographics, presentation and outcome data recorded. These data were compared with historical Scottish data and data published previously by the supraregional liver units.
25 patients were identified, of whom 22 were referred for Kasai in the group A centres, and of whom 19 had a Kasai. 2 year transplant-free survival (TFS) was significantly lower in the SSPGHAN 2002-2009 group than the group A centres in (1) (6/18 (33%) vs 36/57 (63%), p=0.023).
These postrationalisation data are disappointing. The emphasis for care will now focus on improved communication between, primary care, general paediatricians and surgical centres through regional and national managed clinical networks, aiming to improve future outcomes for Scottish children with BA.
评估苏格兰肝外胆道闭锁（EHBA）患儿的治疗结局，这些患儿的治疗服务自 2002 年（“A 组”中心）合理化以来，集中在三个英国中心。
通过苏格兰儿科学胃肠病学、肝脏病学和营养学学会（SSPGHAN）的临床医生，确定了 2002 年至 2009 年间所有被诊断为 EHBA 的苏格兰儿童。进行病例记录回顾，记录人口统计学、表现和结局数据。将这些数据与苏格兰的历史数据和以前由区域肝脏单位发表的数据进行比较。
确定了 25 名患儿，其中 22 名在 A 组中心接受了 Kasai 手术，其中 19 名患儿进行了 Kasai 手术。与 A 组中心相比，SSPGHAN 2002-2009 组的 2 年无移植生存率（TFS）显著降低（1）（6/18（33%）比 36/57（63%），p=0.023）。
这些合理化后的结果令人失望。现在，将通过区域和国家管理临床网络，重点关注初级保健、普通儿科医生和外科中心之间的沟通改善，旨在提高苏格兰 BA 患儿的未来治疗结局。
