To Discuss The Feasibility Of Using Ratio Index APRI For The Pre Operation Assessment Of Biliary Tract Re-operation And The Perioperative Management Principles For Hepatocirrhosis Patients

Aim To discuss the feasibility of using ratio index APRI for the pre operation assessment of biliary tract re-operation for hepatocirrhosis patients, as well as the performance comparison with other evaluation index. The perioperative management principles for biliary tract re-operation for hepatocirrhosis patients have also been discussed.Methods From January 2005 to July 2015,the experience of surgical treatment for the biliary tract re-operation accompanied with hepatocirrhosis in 47 patients was analyzed retrospectively.Results The liver function of 47 patients included Child-Pugh A(22 cases),Child-Pugh B(23 cases),Child-Pugh C(2 cases).Post-operative complications: wound infection(5 cases), intra-abdominal hemorrhage(3 cases),intra-abdominal infection(3 cases), pulmonary infection and effusion(3 cases), bile leakage(2 cases),stress ulcer hemorrhage(2 cases),multiple organ failure and death(1 case). The ratio index APRI,MELD score and Child-Pugh score as test variables drawing the ROC curve. It can be obtained the area which under APRI curve is the largest.Conclusion The value of ratio index APRI in assessing the patients with biliary tract re-operation accompanied with hepatocirrhosis before operation is higher than other indexes. The biliary tract re-operation accompanied with hepatocirrhosis increase the risk of surgical procedures,but reinforce the preoperative management can increase the success rate of operation and decrease the operative mortality and incidence of complication.