目的分析胆道闭锁患儿肝移植术后胆管炎的发生情况。方法回顾性分析2013年1月至2016年7月于本院移植科接受肝移植手术的219例胆道闭锁患儿临床资料。根据肝移植术前是否接受过肝门-空肠吻合术(Kasai手术)、肝移植术前是否发生胆管炎以及肝移植术中肠袢的不同处理方式进行分组,并比较各组间肝移植术后胆管炎的发生率。结果 219例胆道闭锁患儿肝移植术后胆管炎的总体发生率为23.29%。Kasai手术组肝移植术后胆管炎的发生率高于非Kasai手术组(30.70%vs 15.24%),差异有统计学意义(χ~2=7.316,P=0.007)。而Kasai手术组患儿中,术前胆管炎组与术前非胆管炎组肝移植术后胆管炎的发生率组间比较(28.57%vs 32.76%),差异无统计学意义(χ~2=0.235,P=0.628);肠袢保留组与肠袢重建组肝移植术后胆管炎的发生率组间比较(31.43%vs30.38%),差异无统计学意义(χ~2=0.013,P=0.911)。在Kasai术后存在胆管炎的患儿中,原肠袢组与新肠袢组肝移植术后胆管炎发生率组间比较(33.33%vs 24.14%),差异无统计学意义(χ~2=0.579,P=0.447)。结论对于胆道闭锁患儿Kasai术后的顽固性胆管炎,肝移植手术可取得较为满意的结果。胆道闭锁患儿肝移植术后胆管炎较为常见,但基本可以治愈。保证胆肠吻合的输入端肠袢长度足够,可有效控制肝移植术后胆管炎的发生。 Objective To analyze the incidence of cholangitis after liver transplantation in children with biliary atresia. Methods The clinical data of 219 cases of biliary atresia received liver transplantation from January 2013 to July 2016 in our hospital were retrospectively analyzed. According to whether hepatic portal-jejunostomy (Kasai surgery) before liver transplantation, cholangitis occurred before liver transplantation and the different treatment of intestinal gut in liver transplantation were grouped according to different groups and compared between groups after liver transplantation The incidence of cholangitis. Results The overall incidence of cholangitis in 219 children with biliary atresia after liver transplantation was 23.29%. The incidence of cholangitis after liver transplantation in Kasai surgery group was significantly higher than that in non-Kasai surgery group (30.70% vs 15.24%) (χ ~ 2 = 7.316, P = 0.007). In Kasai group, the incidence of cholangitis after liver transplantation in preoperative cholangitis group was significantly higher than that in non-cholangitis group (28.57% vs 32.76%) (χ ~ 2 = 0.235, P = 0.628). There was no significant difference between the two groups (31.43% vs 30.38%) in the incidence of cholangitis after intestinal transplantation between the bowel retention group and the bowel reconstruction group (χ ~ 2 = 0.013, P = 0.911). Among the children with cholangitis after Kasai surgery, the incidence of cholangitis after liver transplantation in the group of original intestine and the group of new intestine was 33.33% vs 24.14%, with no significant difference (χ ~ 2 = 0.579, P = 0.447). Conclusion For patients with biliary atresia after Kasai intractable cholangitis, liver transplantation surgery can be more satisfactory results. Cholangitis after biliary atresia in children with cholangitis is more common, but the basic can be cured. Ensure the bile duct anastomosis at the input end gut length enough to effectively control the occurrence of cholangitis after liver transplantation.