胆道闭锁手术治疗进展

来源 :中华小儿外科杂志 | 被引量 : 0次 | 上传用户:BeginJava123
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胆道闭锁是严重威胁生命的小儿肝胆外科疾病,手术是唯一的治疗方式。Kasai手术是治疗胆道闭锁的首选手术方案,术后约60%的患儿会出现并发症,如胆管炎、肠梗阻、吻合口狭窄、胆漏和消化道出血等,2~5年内约有50%的患儿会发展为肝硬化、肝衰竭,需要肝移植。Kasai手术和肝移植序贯结合可明显改善预后。本文总结了国内外对胆道闭锁手术治疗的研究报道,分别从Kasai手术年龄、手术技巧,腹腔内、外Kasai手术,微创与开腹Kasai手术,再次Kasai手术,肝移植等方面对胆道闭锁手术治疗进展进行综述。“,”Biliary atresia (BA) is a severe life-threatening pediatric hepatobiliary condition. Kasai portoenterostomy acts as a first-line treatment for BA. Around 60% of BA patients develop such postoperative complications as cholangitis, intestinal obstruction, anastomotic stricture, bile leakage and gastrointestinal bleeding, etc. And around one half of them develop cirrhosis and liver failure within 2-5 years and liver transplantation is often required. Sequential combination of Kasai portoenterostomy and liver transplantation significantly improves the prognosis. This review summarized the latest domestic and international researches of surgical treatments for BA from the perspectives of operative age, surgical techniques, intra/extra-abdominal Kasai, mini-invasive versus open Kasai, redo Kasai and liver transplantation, etc.
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