20-year transplant-free survival of biliary atresia after Kasai operation

• DOI: 10.3760/cma.j.issn.0253-3006.2014.04.007
• Publication Date: 2014-04-15
• Authors: Zhihai Zhong; Huadong Chen; Lie Huang; Hong Jiang; Zhichong Zhang; Juncheng Liu

Objective To review the clinical features of BA (biliary atresia) patients surviving over 20 years after Kasai operation without liver transplantation and summarize their prognostic factors.Methods A total 37 diagnosed surgically treated at our center from March 1989 to 1993 were studied retrospectively.There 22 males 15 females.Their operative ages ＜60 (n =6),61-80 =14),81-100 =14) ＞100 =3) days respectively.All them classified as type Ⅲ BA.Among them,7 4 females survived transplantation.Their long-term transplant-free survival rate,gender,operative age,occurrence early postoperative cholangitis hilar bile duct obstruction analyzed.Results The age was (n=3),61-80 =4),81-100 (n=3) ≥100 (n=1) days.The had no statistic significance toward survival(x2 =1.669,P＝ 0.644).In 26 patients,cholangitis occurred within 1 month,5 with achieved survival.The other 11 did not experience cholangitis,and 6 these obtained survival.There statistical between or (x2 =4.614,P =0.032).Seven underwent reoperation portojejunal anastomosis for obstruction,in which 2 survival.Conclusions procedure is an effective method treatment BA,some can obtain influenced prognosis a certain (＜100 days) it most significant factor.Early one major factors determining survival.Early also cause so significantly reduce rate.However,reoperation may still lead survival.

Key words: Biliary atresia; Portoenterostomy; Prognosis