Abstract: Objective To analyze the relationship between the degree of hepatic fibrosis, the inflammatory cell infiltration and the postoperative cholangitis after Kasai operation in children with biliary atresia (BA). Methods A total of 92 children diagnosed as BA in our hospital from January 2015 to December 2016 were selected in this study. Patients were divided into hepatic fibrosis grade Ⅰgroup (n=8), hepatic fibrosis grade Ⅱ group (n=31), hepatic fibrosis grade Ⅲ group (n= 35) and hepatic fibrosis grade Ⅳ group (n=18), according to Japan’s Ohkuma’s hepatic fibrosis grading criteria. Combined with Kasai age, the relationship between hepatic fibrosis and surgical age was analyzed. Samples of liver tissues were evaluated by hematoxylin / eosin (HE) and Masson staining. The expressions of specific inflammatory cell marker antibody LCA, CD4, CD8 and CD68 in liver were observed by IHC staining. Combined with the postoperative follow-up data of Kasai, the relationship between the degree of inflammatory infiltration of liver tissue, the degree of hepatic fibrosis and the postoperative cholangitis of Kasai in BA children was analyzed. Results Routine pathological staining showed that lymphocytes infiltrated mainly in liver tissue. The expression levels of LCA and CD4 were higher in groupⅠand group Ⅳ compared with those of group Ⅱ and group Ⅲ . There was no significant difference in the CD8 expression between four groups. All 92 children with BA were followed up. It was found that cholangitis occurred in 50 cases, early cholangitis occurred in 38 cases, and frequent cholangitis occurred in 23 cases. The incidence of cholangitis, early cholangitis, and frequent cholangitis after Kasai surgery was statistically significant in BA patients with different grades of hepatic fibrosis (P＜0.05). The incidence of cholangitis was higher in the group Ⅰ and group Ⅳ than that in group Ⅱ and group Ⅲ .Conclusion The occurrence of cholangitis after Kasai operation in children with BA is correlated with the hepatic fibrosis and liver inflammatory cells, especially T lymphocyte subgroups.

Key words: biliary atresia, liver cirrhosis, cholangitis, inflammatory infiltrates, Kasai operation