天津医药

天津医药 ›› 2022, Vol. 50 ›› Issue (1): 1-4.doi: 10.11958/20211092

• 胆道闭锁专题 •    下一篇

胆道闭锁Kasai术后胆管炎的发病机制探讨

詹江华，李梦迪   

  1. 天津市儿童医院普外科（邮编300134）
  • 收稿日期:2021-05-11 修回日期:2021-07-08 出版日期:2022-01-15 发布日期:2022-01-19
  • 通讯作者: 詹江华 E-mail:zhanjianghuatj@163.com
  • 基金资助:
    天津市卫生行业重点攻关项目（14KG129） 

The study on pathogenesis of cholangitis after Kasai procedure in children with biliary atresia 

ZHAN Jianghua, LI Mengdi   

  1. Department of General Surgery, Tianjin Children’s Hospital, Tianjin 300134, China
  • Received:2021-05-11 Revised:2021-07-08 Published:2022-01-15 Online:2022-01-19
  • Contact: zhanjianghua E-mail:zhanjianghuatj@163.com

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摘要：

摘要：胆管炎是胆道闭锁Kasai术后的常见并发症，对患儿的生活质量及自肝生存均有较大影响。术中患儿自身肝脏状况会影响术后胆汁引流，Kasai术后胆管炎的发生与胆汁引流状况关系密切。空肠胆支内存在的细菌因肠道环境改变而大量繁殖可能是胆管炎发生的主要原因，远端空肠内容物反流入空肠胆支中也可诱发胆管炎。除了直接逆行感染外，肠道细菌突破肠黏膜经门静脉入肝，也是导致胆管炎发生的原因之一。

关键词: 胆道闭锁, 胆管炎, 肠杆菌科, 肠内容物反流, 肝门空肠吻合术

Abstract:

Abstract: Cholangitis is among the most common complication after Kasai procedure in children with biliary atresia, which has great impact on the quality of life and native liver survival of children. The liver condition during Kasai operation can affect the postoperative bile drainage. The incidence of cholangitis after Kasai operation is associated with bile drainage. The proliferation of bacteria within the bile conduit of jejunum due to the change of intestinal environment maybe the main cause of cholangitis. Intestinal content reflux after Kasai operation may also induce the occurrence of cholangitis. In addition to the direct retrograde infection, enteric bacteria can also break through the intestinal mucosa and enter the liver through the portal vein to induce cholangitis.

Key words: biliary atresia, cholangitis, enterobacteriaceae, intestinal reflux, Kasai procedure

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