Vic P, Gestas P, Mallet E C, Arnaud J P
Service de pédiatrie, centre hospitalier territorial, Tahiti, Polynésie française.
Arch Pediatr. 1994 Jul;1(7):646-51.
French Polynesia includes several ethnic groups; thus, it is well suited for evaluation of racial incidence of extrahepatic biliary atresia (BA). On the other hand, its geographic localization, far from specialized centers, does not facilitate early referral, indispensable for effective surgery.
The files of 17 infants with BA, born in French Polynesia between 1 December 1981 and 1 December 1991, were retrospectively studied. During this period, there were 53,111 live births.
The incidence of BA was 1/3,124. There were eight boys and nine girls; all belonged to the Maohi ethnic group (67% of the total population). They were admitted at the mean age of 71 +/- 33 days (range: 15-120 days); 15 of them were transferred to France at a mean age of 80 +/- 38 days (range: 35-150 days) and were operated on at 99 +/- 43 days (range: 48-195 days). The Kasai procedure was effective in four patients, with a follow-up ranging from 7 to 10 years. Among the 11 other patients, two underwent liver transplantation, four are waiting for transplantation and four have died.
The influence of race on the incidence of BA has not been statistically established here even though this incidence appears high in French Polynesia and similar to Chinese babies in Hawaii. Local geographic conditions explain late admission in pediatric Units whereas possibilities for early surgery are improving.
法属波利尼西亚包含多个种族群体,因此,它非常适合用于评估肝外胆道闭锁(BA)的种族发病率。另一方面,其地理位置远离专业中心,不利于早期转诊,而早期转诊对于有效手术而言必不可少。
对1981年12月1日至1991年12月1日期间在法属波利尼西亚出生的17例BA患儿的病历进行回顾性研究。在此期间,共有53,111例活产婴儿。
BA的发病率为1/3,124。其中有8名男孩和9名女孩;均属于毛利族(占总人口的67%)。他们的平均入院年龄为71±33天(范围:15 - 120天);其中15例在平均年龄80±38天(范围:35 - 150天)时被转至法国,并在99±43天(范围:48 - 195天)时接受手术。4例患者接受Kasai手术有效,随访时间为7至10年。在其他11例患者中,2例接受了肝移植,4例正在等待移植,4例已死亡。
尽管法属波利尼西亚的BA发病率似乎较高且与夏威夷的华裔婴儿相似,但种族对BA发病率的影响在此尚未得到统计学证实。当地的地理条件导致患儿较晚入住儿科病房,不过早期手术的可能性正在改善。