肝门部胆管囊性扩张症 IIIB 型的预后

The Prognosis of Type III Biliary Atresia with Hilar Cyst.

机构信息

Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, The First Affiliated Hospital of Sun Yat-Sen University, No. 58 Zhongshan Road 2, Guangzhou, 510080, China.

Department of Pediatric Surgery, The First Affiliated Hospital of Sun Yat-Sen University, No. 58 Zhongshan Road 2, Guangzhou, 510080, China.

出版信息

Indian J Pediatr. 2021 Jul;88(7):650-655. doi: 10.1007/s12098-020-03561-z. Epub 2020 Nov 20.

DOI:10.1007/s12098-020-03561-z

PMID:33216321

Abstract

OBJECTIVE

To compare the outcome of biliary atresia (BA) patients with and without hilar cyst on preoperative ultrasound.

METHODS

A single center retrospective review of patients of BA with (n = 27) and without hilar cyst (n = 27) over a 5 y period was done. The patients were analyzed using propensity score matching to reduce selection bias. All patients were diagnosed as type III BA by histologic examination and cholangiograms. Clinicopathological characteristics and survival outcomes were compared between the two groups.

RESULTS

There were no significant intergroup differences between baseline characteristics and outcomes after Kasai portoenterostomy surgery in two groups. BA with hilar cyst group showed comparable survival outcomes to the BA without cyst group (cumulative 1-y, 2-y and 5-y overall survival rates with native liver 61.4% vs. 65.8%, P = 0.041; 45.0% vs. 49.0%, P = 0.57; 45.0% vs. 49.0%, P = 0.57). And the Kaplan-Meier survival curves showed no significant difference in cumulative survival with native liver between the two groups (P = 0.58).

CONCLUSIONS

Type III BA with hilar cyst had no better prognosis compared with Type III BA without cyst.

摘要

目的

比较术前超声有和无肝门部囊肿的胆道闭锁（BA）患者的结局。

方法

对 5 年内（n=27）有肝门部囊肿和无肝门部囊肿（n=27）的 BA 患者进行单中心回顾性研究。为了减少选择偏倚，使用倾向评分匹配对患者进行分析。所有患者均通过组织学检查和胆管造影诊断为 III 型 BA。比较两组的临床病理特征和生存结局。

结果

两组患者的基线特征和 Kasai 门腔分流术后的结局无显著差异。有肝门部囊肿的 BA 组与无囊肿的 BA 组的生存结局相当（累积 1 年、2 年和 5 年的总体生存率，带肝生存分别为 61.4%比 65.8%，P=0.041；45.0%比 49.0%，P=0.57；45.0%比 49.0%，P=0.57）。Kaplan-Meier 生存曲线显示两组带肝生存率无显著差异（P=0.58）。