·The clinical data of the patients diagnosed as having type Ⅲ biliary atresia, who underwent Kasai's operation in Shengjing Hospital of China Medical University from January 2012 to January 2018, were analyzed retrospectively. According to the prognosis, the children were divided into jaundice clearance group (JC group, which was divided further into early and late JC group) and jaundice non-clearing group (JOC group), or native liver survival group and non-native liver survival group (liver transplantation/death). T/U test, χ² test, Kaplan-Meier survival analysis, and multivariate Cox regression analysis were employed to analyze the prognostic factors.

·A total of 96 patients were enrolled in this study, including 48 males and 48 females. The average age of operation was (62.1±18.9) d, and the average follow-up time was (16.2±20.3) months. Direct bilirubin decreased to normal within 6 months postoperatively in 61 cases (63.5%). Compared with the JOC group, the indirect bilirubin (IBIL) level was higher and the albumin level was lower in the JC group before operation (both P<0.05). The result of Kaplan-Meier survival curve analysis showed that the native liver survival rates at 3, 6, 12 and 24 months after operation were 92.3%, 70.9%, 57.8% and 55.8%, respectively. The native liver survival rate of the JC group was higher than that of the JOC group (P=0.000). The rate was also higher in the early JC group when compared with the late JC group (P=0.001). Multivariate Cox regression analysis revealed that gender of male [P=0.049, RR=2.163 (95%CI 1.076?4.797)] and jaundice clearance [P=0.001, RR=11.488 (95%CI 2.726?48.415)] were the protective factors of 2-year native liver survival rate.

·Preoperative IBIL and albumin levels may affect jaundice clearance in the children with type Ⅲ biliary atresia after portoenterostomy; gender of male and jaundice clearance are protective factors for 2-year native liver survival in these children.