Kvist N E, Thorup J M, Nielsen O H
Børnekirurgisk afdeling, Rigshospitalet, København.
Ugeskr Laeger. 1993 Jun 28;155(26):2053-5.
Long-term survival of biliary atresia patients after Kasai hepatoportoenterostomy is being increasingly reported. Favorable prognostic factors are: 1) Young age at operation (max. 60 days). 2) Few incidents of postoperative cholangitis. Jaundice-free long-term survival is achieved in one-fourth to one-third of patients undergoing Kasai hepatoportoenterostomy. Without treatment the average life span is 19 months. Twenty infants with biliary atresia were treated with the Kasai operation between 1976 and 1992. Nine children are alive 11 months to 16 years postoperatively, two after a liver replacement, one at ten months and one at two and a half years old. A tenth child had a well functioning anastomosis but died of heart failure. Eight children with a well functioning anastomosis were all younger than 60 days at the operation. Only one child older than 60 days survived without a liver transplantation. Our results confirm that early diagnosis and treatment of biliary atresia, before 60 days of age, is necessary.
越来越多的报告称，接受肝门空肠吻合术的胆道闭锁患者实现了长期存活。有利的预后因素包括：1）手术时年龄小（最大60天）。2）术后胆管炎发生率低。接受肝门空肠吻合术的患者中有四分之一到三分之一实现了无黄疸长期存活。未经治疗的平均寿命为19个月。1976年至1992年间，20例胆道闭锁婴儿接受了肝门空肠吻合术治疗。9名儿童术后11个月至16年存活，其中2名在肝移植后存活，1名在10个月时存活，1名在2岁半时存活。第10名儿童吻合口功能良好，但死于心力衰竭。8名吻合口功能良好的儿童手术时均小于60天。只有1名60天以上的儿童在未进行肝移植的情况下存活。我们的结果证实，在60日龄之前对胆道闭锁进行早期诊断和治疗是必要的。
