Redkar Rajeev, Karkera Parag J, Raj Vinod, Bangar Anant, Hathiramani Varun, Krishnan Janani
Department of Pediatric Surgery, Lilavati Hospital and Research Centre; and Department of Pediatric Surgery, Bai Jerbai Wadia Hospital for Children, Parel; Mumbai, India. Correspondence to: Dr Rajeev Redkar, 14, Buildarch Terrace, 1st Floor, Sitladevi Temple Road, Mahim, Mumbai 400 016, India.
Indian Pediatr. 2017 Apr 15;54(4):291-294. doi: 10.1007/s13312-017-1091-5. Epub 2017 Feb 2.
To study the outcome of Biliary atresia after Kasai's portoenterostomy and clinical and biochemical factors affecting the outcome.
Medical record review of patients of biliary atresia operated from January 2000 to December 2014. The following data were collected and analyzed - sex, age at surgery, liver function tests, associated congenital anomalies, and clearance of jaundice (at 3 months). Final outcome was classified as alive, dead, or jaundice-free at last follow-up (minimum 1 year).
121 patients (61.9% males) were included; 32 (26.5%) were lost to follow-up at 1 year. At last follow-up, out of the 89, 42 (47.2%) were alive, 29 (32.6%) were jaundice-free, and 47 (52.8%) had died. The native liver survival rate at last follow up was 43.8%. 42 (47.2%) patients had complete clearance of jaundice at 3 months post-procedure. Jaundice-clearance rate was significantly high in patients alive (83.3% vs 16.7%, P<0.001)) as compared to those who died later.
Jaundice clearance at 3 months post surgery is a good early indicator of long term success.
研究肝门空肠吻合术后胆道闭锁的预后以及影响预后的临床和生化因素。
回顾性分析2000年1月至2014年12月接受手术治疗的胆道闭锁患者的病历。收集并分析以下数据——性别、手术年龄、肝功能检查、相关先天性畸形以及黄疸清除情况（术后3个月）。最终结局分为存活、死亡或末次随访时无黄疸（最短随访1年）。
纳入121例患者（61.9%为男性）；32例（26.5%）在1年时失访。在末次随访时，89例患者中，42例（47.2%）存活，29例（32.6%）无黄疸，47例（52.8%）死亡。末次随访时自体肝存活率为43.8%。42例（47.2%）患者在术后3个月黄疸完全清除。与后期死亡的患者相比，存活患者的黄疸清除率显著更高（83.3%对16.7%，P<0.001）。
术后3个月黄疸清除是长期成功的良好早期指标。
