Factors Affecting The Prognosis Of Biliary Atresia After Kasai Portoenterostomy

Objective:To analyze factors affecting jaundice regression and native liver survival(NLS)in patients with biliary atresia(BA)after Kasai portoenterostomy(KPE).Methods:The clinical data of patients with type III BA after KPE which diagnosed and operated in our hospital from January 2011 to August 2020 were analyzed.We counted the jaundice clearance rate and 2-year NLS in postoperative patients.Using statistical analysis methods such as student’s t test,Mann-Whitney U test,X 2 test,logistic regression analysis,Kaplan-Meier survival analysis and Cox regression model to compare and analyze the possible related factors affecting jaundice clearance rate and 2-year NLS.P<0.05 was set as statistically significant.Results:A total of 138 cases were included in this study,included 66 men and 72 women.The rate of jaundice regression after KPE operation was 66%.The NLS was83.7%,66.3%,54.3% and 50% in 3 months,half a year,1 year and 2 year after operation.The operation age of CMV-Ig M negative children was lower than that of CMV-Ig M positive children(p<0.05).The AST value and ALT value of the children whose operation age was greater than 60 days old were higher than that of the children whose operation age was not greater than under 60 days old(P<0.05),and the jaundice clearance rate was lower(P<0.05).The preoperative TBA value of jaundice-clearanced was lower than non-jaundice-clearanced group(p<0.05).The preoperative TB 、 DB value in the early jaundice clearance group was lower than that in the late jaundice clearance group(p<0.05).The 2-year NLS of jaundice regression group was significantly higher than that of another group(p<0.05).The risk of liver transplantation or death of the non-jaundice-clearanced group was 8.979 times more than the jaundiceclearanced group.Conclusion: The operative age,preoperative TBA value,TB value and DB value of children with biliary atresia affect the jaundice clearance rate after operation.Jaundice regression affects the 2-year NLS and is a prognostic factor of biliary atresia.