The Prognostic Factor Analysis And Countermeasures After Kasai Operation For Biliary Atresia

Objective: In 1955,Japanese Mr.Kasai had initiatived Kasai surgery.The first patient of Kasai Surgery with the longest survival time was 33 years.with the liver transplantation in children were applied to the biliary atresia,allowing children to long-term survival nearly 30 years,but there is no one more than the record of Mr Kasai.The long-term effect is still not clear,Kasai Surgery is still the preferred treatment for the children with biliary atresia.To exploring the prognostic factors associated with biliary atresia(BA),we can realize the current situation of the treatment of the disease in our province and explore the factors that affect the prognosis of the disease.Methods:Retrospective analyses were performed for 91 children undergoing Kasai operation at Children’s hospital of Shanxi Province.Follow-ups were conducted with complete data during January 2009 to December 2015.The survival rate was estimated by Kaplan-Meier method.The prognosis factors were analyzed by univariate(log rank)and multivariate(Cox mode)anailsis methods.Results:The 6month,1-and 2year overall survival rates were 76.92%、48.35%、36.26% respectively.The survival rates of operative day age d<60、60≤d<90、90≤d<120、d≥120 days groups were 58.8%、46.3%、11.1%、0 respectively(p=0.047);The survival rates of cholangitis attack or not were 41.9% and 75.0% respectively(p=0.009);The survival rates of Jaundice subsided significantly or not were 50.8% and 23.3% respectively(p=0.012);The survival rates of liver function recovery were 56.6% and 21.1% respectively(p=0.01);The survival rates of type of BA groups were 77.8%、66.7%、31.6% respectively(p=0.023).Conclusions:The univariate analysis showed that operation age,cholangitis attack,jaundice subsided,liver function recovery,type of BA were statistical significance for prognosis of Kasai operation.Operation age,jaundice subsided and liver function recovery was comfirmed as independent prognostic factor.It is important that Improve the level of people’s perception of biliary atresia,strengthening postoperative follow-up evaluation to improve the biliary atresia survival rate.