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腹腔镜 Kasai 门腔分流术治疗胆道闭锁 49 例的中期结果。

Medium-term Outcome of Laparoscopic Kasai Portoenterostomy for Biliary Atresia With 49 Cases.

机构信息

Department of Pediatric Surgery.

Pediatric Intensive Care Unit, Department of Critical Care Medicine, West China Hospital of Sichuan University, Chengdu, China.

出版信息

J Pediatr Gastroenterol Nutr. 2018 Jun;66(6):857-860. doi: 10.1097/MPG.0000000000001934.

Abstract

OBJECTIVE

The aim of this study was to evaluate the mid-term results of laparoscopic Kasai portoenterostomy (LKPE) for biliary atresia (BA) at our hospital.

METHODS

From May 2009 to May 2012, the charts of infants with BA who underwent LKPE were reviewed retrospectively. The clearance of jaundice (CJ) as well as 3-year, and 5-year survival with native liver (SNL) rates were analyzed and compared with those after open Kasai portoenterostomy (OKPE).

RESULTS

Forty-nine patients with BA who underwent LKPE were assigned to group A, and 40 patients with BA who underwent OKPE were assigned to group B. All patients in both groups had type III non-syndromic BA, and the LKPE and OKPE procedures were performed by 2 different surgical teams at our hospital. After median follow-up periods of 77 months in group A and 79 months in group B, the CJ and 3- and 5-year SNL rates were 61.2%, 55.1%, and 36.7% in group A, and 45.0%, 37.5%, and 25.0% in group B, respectively. The difference of CJ between group A and group B was not significant. The Kaplan-Meier method analysis showed that the difference in SNL between group A and group B was not significant either.

CONCLUSIONS

LKPE for patients with BA was a technically feasible and alternative procedure to OKPE. The 3- and 5-year SNL rates after LKPE were not different compared to those after OKPE.

摘要

目的

本研究旨在评估我院腹腔镜胆肠吻合术(LKPE)治疗胆道闭锁(BA)的中期结果。

方法

回顾性分析 2009 年 5 月至 2012 年 5 月我院收治的行 LKPE 的 BA 患儿的病历。分析并比较了黄疸消退(CJ)率以及 3 年和 5 年的自体肝存活率(SNL)率,并与开腹胆肠吻合术(OKPE)后的结果进行比较。

结果

49 例 BA 患儿行 LKPE 归入 A 组,40 例 BA 患儿行 OKPE 归入 B 组。两组患儿均为 III 型非综合征型 BA,LKPE 和 OKPE 均由我院 2 个不同的外科手术团队完成。A 组中位随访 77 个月,B 组中位随访 79 个月后,A 组的 CJ 以及 3 年和 5 年 SNL 率分别为 61.2%、55.1%和 36.7%,B 组分别为 45.0%、37.5%和 25.0%。A 组与 B 组的 CJ 差异无统计学意义。Kaplan-Meier 法分析显示,A 组与 B 组的 SNL 差异也无统计学意义。

结论

对于 BA 患儿,LKPE 是一种可行的替代 OKPE 的手术方法。LKPE 后 3 年和 5 年的 SNL 率与 OKPE 后无差异。

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