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胆道闭锁:序贯治疗和一期肝移植如何选择

Biliary atresia:how to choose between sequential treatment and primary liver transplantation

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所有的胆道闭锁患儿是否都应该进行肝门空肠吻合术(Hepatoportoenterostomy,HPE)以及前期的HPE手术是否会对肝移植产生不良影响是值得深思的问题.随着活体肝移植技术的进展,如何区分哪些患儿能从一期肝移植中获益,也是摆在儿外科医生面前的挑战.本研究将从HPE手术术后自体肝长期生存状况、续贯治疗中前期HPE手术对后期肝移植的影响、术前判断HPE手术自体肝预后的指标等三个方面对胆道闭锁患儿两种手术治疗方案的选择依据进行综述.
Whether or not hepatoportoenterostomy(HPE)should be performed on all children of biliary atresia(BA)and whether HPE has some adverse effect on sequential liver transplantation(SLT)are thought-provoking.With the development of living donor liver transplantation,distinguishing BA patients benefiting from primary liver transplantation(PLT)has remained a great challenge for pediatric surgeons.Literature review was conducted with regards to long-term survival of native liver after HPE,impact of HPE on SLT and preoperative indicators for evaluating the prognosis of patients.

Biliary atresiaSurgical treatmentHepatoportoenterostomyLiver transplantation

任雪、陈功

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复旦大学附属儿科医院普外科,上海 201102

胆道闭锁 手术治疗 肝门空肠吻合术 肝移植

上海申康医院发展中心临床三年行动计划上海市临床重点专科建设项目

SHDC2020CR2009ASHSLCZDZK05703

2024

中华小儿外科杂志
中华医学会

中华小儿外科杂志

CSTPCD北大核心
影响因子:0.853
ISSN:0253-3006
年,卷(期):2024.45(5)