Suppr超能文献

胆道闭锁——临床系列

Biliary Atresia - Clinical Series.

作者信息

Neto Bárbara, Borges-Dias Mariana, Trindade Eunice, Estevão-Costa José, Campos José Miguel

机构信息

Department of Pediatric Surgery, Centro Hospitalar São João, Faculdade de Medicina da Universidade do Porto, Porto, Portugal.

Department of Pediatrics, Centro Hospitalar São João, Faculdade de Medicina da Universidade do Porto, Porto, Portugal.

出版信息

GE Port J Gastroenterol. 2018 Mar;25(2):68-73. doi: 10.1159/000480708. Epub 2017 Oct 5.

Abstract

INTRODUCTION

Biliary atresia is the main cause of death by hepatic failure and the main indication for liver transplant in children. This study aims to analyze the population with this diagnosis, treated between 2000 and 2015 at Hospital de São João.

MATERIAL AND METHODS

Descriptive, observational, and retrospective study, including the patients with biliary atresia, diagnosed and treated between January 1, 2000 and December 31, 2015. We analyzed epidemiologic, clinical, biochemical, and image data, as well as registered complications and present status.

RESULTS

Eighteen patients were evaluated. The median age at time of Kasai portoenterostomy was 63 days of life, with better prognosis for those patients who had surgery before 72 days. The procedure was successful in 2/3 of cases. There was a significant association between recurrent cholangitis and survival. Five cases of transplant and 2 deaths, one of them after transplant, were registered. Survival with native liver was 77.8%, 72.2%, and 64.2% at 1, 5, and 10 years of follow-up, respectively.

DISCUSSION

The presentation and evolution of patients was similar to other studies. However, there was a higher surgical success and survival rates at 5 and 10 years of follow-up than most series. Age at surgery and recurrence of cholangitis were the only factors significantly related to prognosis.

CONCLUSION

In spite of the low number of patients (1,125/year), our results were similar to those of other reference centers.

摘要

引言

胆道闭锁是导致儿童肝衰竭死亡的主要原因,也是儿童肝移植的主要适应症。本研究旨在分析2000年至2015年期间在圣若昂医院接受治疗的该诊断患者群体。

材料与方法

描述性、观察性和回顾性研究,纳入2000年1月1日至2015年12月31日期间诊断并接受治疗的胆道闭锁患者。我们分析了流行病学、临床、生化和影像数据,以及记录的并发症和现状。

结果

评估了18例患者。接受葛西肝门肠吻合术时的中位年龄为63天,72天前接受手术的患者预后较好。该手术在2/3的病例中成功。复发性胆管炎与生存率之间存在显著关联。记录了5例移植病例和2例死亡病例,其中1例在移植后死亡。随访1年、5年和10年时,自体肝生存率分别为77.8%、72.2%和64.2%。

讨论

患者的表现及病情演变与其他研究相似。然而,随访5年和10年时的手术成功率和生存率高于大多数系列研究。手术年龄和胆管炎复发是仅有的与预后显著相关的因素。

结论

尽管患者数量较少(每年1125例),但我们的结果与其他参考中心相似。

相似文献

1
Biliary Atresia - Clinical Series.胆道闭锁——临床系列
GE Port J Gastroenterol. 2018 Mar;25(2):68-73. doi: 10.1159/000480708. Epub 2017 Oct 5.
6
The Kasai portoenterostomy: when is it too late?肝门空肠吻合术:何时为时已晚?
J Pediatr Surg. 2001 Jan;36(1):97-9. doi: 10.1053/jpsu.2001.20020.
8
Biliary atresia in Vietnam: Management and the burden of disease.越南的胆道闭锁:疾病管理与负担
Surgery. 2017 Feb;161(2):533-537. doi: 10.1016/j.surg.2016.08.012. Epub 2016 Oct 13.
10
Intrahepatic cystic lesions in children with biliary atresia after Kasai procedure.先天性胆道闭锁术后儿童肝内囊性病变。
J Pediatr Surg. 2019 Dec;54(12):2565-2569. doi: 10.1016/j.jpedsurg.2019.08.027. Epub 2019 Aug 30.

引用本文的文献

8
Biliary Atresia - Too Few, Too Many Centers.胆道闭锁——治疗中心过少还是过多。
GE Port J Gastroenterol. 2018 Mar;25(2):57-58. doi: 10.1159/000484352. Epub 2017 Nov 16.

本文引用的文献

2
Biliary atresia: Clinical advances and perspectives.先天性胆道闭锁:临床进展与展望。
Clin Res Hepatol Gastroenterol. 2016 Jun;40(3):281-287. doi: 10.1016/j.clinre.2015.11.010. Epub 2016 Jan 5.
3
Cholestasis in the newborn and infant.新生儿及婴儿胆汁淤积症
Clin Res Hepatol Gastroenterol. 2014 Jun;38(3):263-7. doi: 10.1016/j.clinre.2014.03.010. Epub 2014 Apr 18.
4
Etiology of biliary atresia as a developmental anomaly: recent advances.先天性胆道闭锁的病因:最新进展。
J Hepatobiliary Pancreat Sci. 2013 Jun;20(5):459-64. doi: 10.1007/s00534-013-0604-4.
5
International incidence and outcomes of biliary atresia.国际胆道闭锁的发病情况和结局。
J Pediatr Gastroenterol Nutr. 2013 Apr;56(4):344-54. doi: 10.1097/MPG.0b013e318282a913.
6
Portal hypertension in children and young adults with biliary atresia.胆道闭锁患儿和青年人群中的门静脉高压症。
J Pediatr Gastroenterol Nutr. 2012 Nov;55(5):567-73. doi: 10.1097/MPG.0b013e31826eb0cf.
8
Biliary disease in children.儿童胆道疾病
Curr Gastroenterol Rep. 2011 Apr;13(2):193-201. doi: 10.1007/s11894-010-0169-1.
9
Clinical practice: management of biliary atresia.临床实践:先天性胆道闭锁的管理。
Eur J Pediatr. 2010 Apr;169(4):395-402. doi: 10.1007/s00431-009-1125-7. Epub 2009 Dec 18.
10
Biliary atresia.胆道闭锁
Lancet. 2009 Nov 14;374(9702):1704-13. doi: 10.1016/S0140-6736(09)60946-6.

文献检索

告别复杂PubMed语法,用中文像聊天一样搜索,搜遍4000万医学文献。AI智能推荐,让科研检索更轻松。

立即免费搜索

文件翻译

保留排版,准确专业,支持PDF/Word/PPT等文件格式,支持 12+语言互译。

免费翻译文档

深度研究

AI帮你快速写综述,25分钟生成高质量综述,智能提取关键信息,辅助科研写作。

立即免费体验