胆道闭锁是一种罕见的儿童疾病，主要表现为新生儿出生后胆管闭塞、胆汁淤积以及进行性肝纤维化。Kasai肝门空肠吻合术是治疗胆道闭锁的首选术式。胆管炎是Kasai手术后最常见的并发症，其病因尚不明确，可能是由于肠道细菌逆行感染导致。有针对性的应用抗生素能有效预防胆管炎的发生，但目前对于抗生素的使用尚无明确方案，近年来人们逐渐意识到短期内使用三代头孢或碳青霉烯类抗生素或许对患儿有益。本文就近年来胆道闭锁术后预防性使用抗生素的研究进展进行相关综述。 As a rare infantile disease, biliary atresia (BA) is manifested postnatally as obstruction of bile ducts, cholestasis and progressive liver fibrosis. Kasai portoenterostomy is a preferred treatment of BA. And cholangitis is the most common complication after Kasai surgery. However, its causes remain elusive probably due to ascending infection of gut bacteria. Targeted antibiotic therapy can effectively prevent the occurrence of cholangitis. However, there is currently no consensus for dosing antibiotics. In recent years, there has been a growing awareness that short-term use of third-generation cephalosporin or carbapenems might be beneficial. This review summarized the latest researches of prophylactic use of antibiotics after Kasai portoenterostomy.
Research advances on prophylactic use of antibiotics after Kasai portoenterostomy for biliary atresia
As a rare infantile disease, biliary atresia (BA) is manifested postnatally as obstruction of bile ducts, cholestasis and progressive liver fibrosis. Kasai portoenterostomy is a preferred treatment of BA. And cholangitis is the most common complication after Kasai surgery. However, its causes remain elusive probably due to ascending infection of gut bacteria. Targeted antibiotic therapy can effectively prevent the occurrence of cholangitis. However, there is currently no consensus for dosing antibiotics. In recent years, there has been a growing awareness that short-term use of third-generation cephalosporin or carbapenems might be beneficial. This review summarized the latest researches of prophylactic use of antibiotics after Kasai portoenterostomy.
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