Surgery for biliary atresia - Is there a European consensus?
Surgery for biliary atresia - Is there a European consensus?
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DOI：
10.1055/s-2007-965147
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发表时间：
2007-06-01
影响因子：
1.8
通讯作者：
Kobayashi, H.
中科院分区：
文献类型：
--
作者：
Davenport, M.;Ure, B. M.;Kobayashi, H.
胆道闭锁（BA）的初始外科治疗包括肝外残留物的根治性切除和门肠吻合术。然而，尽管加塞引入了这种手术，BA仍然是儿科肝移植最常见的适应症。在2007年欧洲胆道闭锁登记会议期间，加塞门肠吻合术技术方面工作组的目标是就儿科外科医生相关的各种手术和围手术期方面达成共识。尽管对加塞手术的一些技术细节仍存在分歧，但在实际手术的大多数领域已出现了显著的共识。在术后引流的作用、类固醇的常规应用、口服预防性抗生素的使用以及术后胆管炎的治疗方面没有达成共识。尽管如此，报告的结果差异很大，这是这次会议的一个特点，这表明仍然有一些领域可以通过技术或实践的变化来预期结果的改善。
Initial surgical therapy of biliary atresia (BA) consists of the radical excision of extrahepatic remnants and portoenterostomy. However, despite this procedure, which was introduced by Kasai, BA remains the commonest indication for paediatric liver transplantation. The goal of the work group on the technical aspects of Kasai portoenterostomy procedures during the European Biliary Atresia Registry Conference 2007 was to achieve consensus on various operative and peri-operative aspects relevant for paediatric surgeons. Although there is still disagreement regarding some of the technical details of the Kasai operation, a remarkable consensus has emerged in most areas of the actual surgery. No consensus was achieved on the role of postoperative drainage, the routine application of steroids, the use of oral prophylactic antibiotics, and the treatment of postoperative cholangitis. Nevertheless, the wide variation in reported results, which was a feature of this conference, suggests that there are still areas where improvement in outcomes can be anticipated by changes in technique or practice.