Progress in the etiology, diagnosis and treatment of cholangitis after biliary atresia Kasai surgery

Jiamei Tang
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Abstract

Biliary atresia is a serious congenital malformation that threatens the life of newborns.At present, the treatment of biliary atresia mainly relies on Kasai portoenterostomy which is also named hepatoportoenterostomy to correct the dysplastic biliary system.Cholangitis is the most common and intractable complication after Kasai portoenterostomy.The pathogenesis is still unidentified.Many factors including ascending infection of intestinal bacteria, abnormal development of intrahepatic bile duct, surgical injury, reflux of intestinal contentscan and so on can affect the occurrence and development of the disease.The initial time and frequency of cholangitis can affect the postoperative primary liver function, so it is especially important to diagnose and treat it timely.The diagnosis of post-Kasai cholangitis is lack of specificity, mainly based on clinical manifestations, biochemical abnormalities and surgical history.For intractable cholangitis should consider completing radioisotope hepatobiliary imaging, percutaneous cholangiography and single or double-balloon enteroscopy.The main focus of prevention and treatment lies in preoperative care, surgical improvement and postoperative care, as well as drug prevention during disease follow-up. Key words: Biliary atresia; Post-Kasai cholangitis; Cause; Diagnosis; Prevention; Treatment
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胆道闭锁开赛手术后胆管炎的病因、诊断和治疗进展
胆道闭锁是一种严重的先天性畸形,威胁新生儿的生命。目前,胆道闭锁的治疗主要依靠Kasai门肠吻合术,也被称为肝门肠吻合术来矫正发育不良的胆道系统。胆总管炎是Kasai门肠吻合术后最常见和最难治的并发症。其发病机制尚不明确。肠道细菌上行感染、肝内胆管发育异常、手术损伤、肠道内容物反流等多种因素都会影响疾病的发生和发展。胆管炎的发病时间和频率会影响术后原发性肝功能,因此及时诊断和治疗尤为重要。Kasai后胆管炎的诊断缺乏特异性,主要基于临床表现、生化异常和手术史。对于顽固性胆管炎,应考虑完成放射性同位素肝胆成像、经皮胆道造影和单或双球囊肠镜检查。预防和治疗的主要重点在于术前护理、手术改善和术后护理,以及疾病随访期间的药物预防。关键词:胆道闭锁;开赛后胆管炎;原因;诊断;预防;治疗
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期刊介绍: Chinese Journal of Neurology was established in 1955, the predecessor of which is Chinese Journal of Neurology and Psychiatry. Chinese Journal of Neurology and Psychiatry has been indexed by MEDLINE until 1996, when it was divided into two journals, Chinese Journal of Neurology, and Chinese Journal of Psychiatry. Chinese Journal of Neurology is now indexed by EM, SCOPUS, AJ, WPRIM, CNKI, Wanfang Data, CSCD, etc. The impact factor of the journal is 2.755 in 2017, ranking the first among all neurological and psychological journals in China and among all the 142 medical journals published by the Chinese Medical Association. The journal is available both in print and online.
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