Analysis Of Prognostic Factors In Kasai Operation For Biliary Atresia

Objective:Observe the survival of native liver in patients with biliary atresia after Kasai operation,and explore the related factors affecting prognosis.Methods:The clinical data of patients diagnosed as congenital biliary atresia complicated with Kasai operation by Shengjing Hospital affiliated to China Medical University from December 2011 to December 2018 were analyzed retrospectively.According to the prognosis of the patients,all patients were divided into two groups:native liver survive group and non native liver survive group(liver transplantation/death).T-test,X~2 test,Kaplan-Meier survival analysis and multivariate Cox regression analysis were used to explore the prognostic factors.P<0.05 was set as statistically significant.Results:Kaplan-Meier survival analysis showed that jaundice clearancewasa protective factor for native liver survival.The survival rate of native liver in early jaundice clearance group was higher than that in late jaundice clearance group(p<0.001).There was significant difference in indirect bilirubin level(p=0.025)and albumin level(p=0.02)between jaundice clearance group and non-jaundice clearance group,but no significant difference among the other indexes.Univariate analysis showed that the age of operation in CMV-IgM(+)group was lower than that in negative group(p<0.001).There was no significant difference in the jaundice clearance rate and survival rate of native liver between the two groups.Univariate analysis showed that the age of operation affected the recovery of liver function(p=0.016),without affecting the jaundice clearance rate.The degree of hepatic fibrosis affected the recovery of liver function after operation(p=0.025),without affecting jaundice clearance rate and survival rate of native liver.Cox multivariate analysis only found that the jaundice clearance(p<0.001)and gender factor(p=0.049)were related to the survival rate of native liver.Conclusion:The survival rate of native liver after Kasai operation was related to gender and jaundice clearance.There were significant difference in indirect bilirubin level and albumin level between jaundice clearance group and non-jaundice clearance group.The survival rate of native liver was higher than that of non-jaundice clearance group.CMV-IgM positive group was younger than negative group when performing the Kasai operation.The age of operation and the degree of hepatic fibrosis affect the recovery of liver function.