从腹腔镜下 Kasai 肝门空肠吻合术到开放 Kasai 肝门空肠吻合术：胆道闭锁婴儿重新采用开放 Kasai 肝门空肠吻合术后的结果
From laparoscopic to open Kasai portoenterostomy: the outcome after reintroduction of open Kasai portoenterostomy in infant with biliary atresia.
作者信息
Chan Kin Wai E, Lee Kim Hung, Wong Hei Yi V, Tsui Siu Yan B, Wong Yuen Shan, Pang Kit Yi K, Mou Jennifer Wai Cheung, Tam Yuk Him
机构信息
Division of Paediatric Surgery and Paediatric Urology, Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, China,
出版信息
Pediatr Surg Int. 2014 Jun;30(6):605-8. doi: 10.1007/s00383-014-3499-5. Epub 2014 Apr 11.
PURPOSE
Apparently superior result was observed after open Kasai portoenterostomy in infant with biliary atresia. Our institute stopped performing laparoscopic portoenterostomy since 2007. We aimed to investigate the outcome after reintroduction of open portoenterostomy.
METHODS
27 non-syndromic infants underwent open Kasai portoenterostomy from 2007 to 2012. The age and the sex of the patient, the bilirubin level before the operation, the early clearance of jaundice (total bilirubin <20 μmol/L within 6 month of portoenterostomy), the native liver survival at 2 years after the operation were reviewed. The results were retrospectively compared with all 16 infants who underwent laparoscopic Kasai portoenterostomy before 2007.
RESULTS
All infants had type III biliary atresia. No statistical difference was observed regarding the age at operation and the pre-operative bilirubin level. The early clearance of jaundice rate was 81% (22/27) after open operation and was 50% (8/16) after laparoscopic operation (p = 0.03). At 2 years after the operation, the native liver survival was 81% (22/27) after open operation and was 50% (8/16) after laparoscopic operation (p = 0.03).
CONCLUSION
Reintroduction of open Kasai portoenterostomy was associated with superior early clearance of jaundice rate and 2-year native liver survival rate.
目的
在患有胆道闭锁的婴儿中，开放性Kasai肝门空肠吻合术后观察到明显更好的结果。自2007年以来，我们研究所停止了腹腔镜肝门空肠吻合术。我们旨在研究重新开展开放性肝门空肠吻合术后的结果。
方法
2007年至2012年期间，27例非综合征性婴儿接受了开放性Kasai肝门空肠吻合术。回顾了患者的年龄和性别、手术前的胆红素水平、黄疸的早期清除情况（肝门空肠吻合术后6个月内总胆红素<20μmol/L）、术后2年的自体肝存活率。将结果与2007年之前接受腹腔镜Kasai肝门空肠吻合术的16例婴儿进行回顾性比较。
结果
所有婴儿均为III型胆道闭锁。在手术年龄和术前胆红素水平方面未观察到统计学差异。开放性手术后黄疸的早期清除率为81%（22/27），腹腔镜手术后为50%（8/16）（p = 0.03）。术后2年，开放性手术后自体肝存活率为81%（22/27），腹腔镜手术后为50%（8/16）（p = 0.03）。
结论
重新开展开放性Kasai肝门空肠吻合术与更高的黄疸早期清除率和2年自体肝存活率相关。
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