胆道闭锁Kasai术后辅助治疗研究进展

摘要：胆道闭锁（BA）是累及肝内外胆管的一种进行性疾病,目前广泛采用的治疗策略是行肝门空肠吻合术（Kasai术）,但约60%的患儿Kasai术后效果不佳,继而需要行肝移植。虽然患儿本身BA分型、手术方式（腹腔镜或传统开放）、手术时年龄、术时肝脏病变情况均是影响BA患儿Kasai术后生存的因素,但是BA术后的辅助治疗仍有较大的改进空间。近年来对于BA术后应用激素、胆汁酸代谢药物、抗生素、益生菌等的报道较多,为了使BA患儿获得更好的预后,该文章就BA术后辅助治疗的研究进展进行综述,进一步探讨辅助治疗改善BA患儿预后的价值。

Research progress of adjuvant therapy after Kasai surgery for biliary atresia

Abstract: Biliary atresia (BA) is a progressive disease involving both intrahepatic and extrahepatic bile ducts. Kasai portoenterostomy is the most widely used treatment strategy for BA. However, about 60% of the patients treated by Kasai operation have poor postoperative outcomes and still need liver transplantation in the future. Although the factors affecting the postoperative survival of children with BA are closely related to the BA classification, the surgical method (laparoscopic or traditional open), the age at the time of surgery, and liver lesions at the time of surgery, the adjuvant therapy after BA is still an area that can be improved to a great extent. In recent years, there have been many reports on postoperative BA, such as hormones, bile acid metabolism drugs, antibiotics and probiotics, etc. In this paper, the research progress of adjuvant therapy after BA is reviewed to further explore the prognostic value of adjuvant therapy in children with BA.