Biliary atresia as a type of hepatobiliary disease poses a serious threat to the lives of newborn infants. With the continuous development of hepatic hilar-jejunostomy (Kasai procedure), the treatment of biliary atresia has entered a whole new scenario, but the prognosis of children with BA faces great challenges and is influenced by several factors, such as the age of the child at surgery, the type of BA, and the degree of liver damage. Some research data show that biliary atresia tends to be more of an acquired disease rather than a congenital one. Furthermore the histological observation of the liver and biliary tract where the lesion occurs again suggests a progressive inflammatory disease [11-12]. Hepatic hilar jejunostomy should be performed as far as possible to achieve good results, mainly because the development of inflammatory lesions can cause further occlusion, sclerosis or even partial disappearance of the bile ducts [13]. Hu Yuanjun, Department of Pediatric Surgery, Jinan Children’s Hospital The results of this study found that the prognostic outcome of children with BA was influenced by the age of the children at the time of surgery, and the children in the observation group were younger and differed significantly (P<0.05) from the mean age of the control group at the time they underwent surgery. Again, it proves that children with BA should be diagnosed as early as possible and treated as soon as possible in order to further stop or delay the development of the lesion and lay the foundation for prognosis [14]. Liver function tests are important in evaluating the outcome of surgery in children with BA, for example, the destruction of hepatocytes is accompanied by an increase in serum transaminases, and poor bile drainage or liver insufficiency can further lead to an increase in serum bilirubin levels. In addition liver fibrosis is an important pathological feature of children with BA is also an important pathophysiological process in various other chronic liver diseases. The results of this study showed that the degree of liver fibrosis in children with BA in the observation group was less severe and in children with BA in the control group was more severe, and the difference between the two was significant (P<0.05). It showed that the degree of liver fibrosis also had an important impact on the prognosis of children with BA, and the more severe the liver fibrosis, the worse the prognosis, and the two were negatively correlated. Further development of liver fibrosis can lead to cirrhosis, liver failure, and eventually death of the child [15]. In addition, the occurrence of episodic cholangitis after hepatic hilar-jejunostomy has a crucial impact on the prognosis. In the cases we observed, five children recovered well in the early postoperative period and could pass golden-yellow stools, jaundice subsided significantly, and all laboratory indicators improved significantly. However, all of them had recurrent episodic cholangitis within six months after discharge from the hospital. Each recurrence of episodic cholangitis caused biliary obstruction and increased liver function damage. All five children died about 1 year after surgery. However, we have observed that there is no pattern to the occurrence of postoperative episodic cholangitis and no effective measures to avoid it. We have tried anti-reflux flaps, immunoglobulin given one week after surgery, and long-term oral cephalosporins of three generations, but no significant effect has been seen. It is an unpredictable and uncontrollable factor. Studies have confirmed that MMP-2 plays an important role in the process of liver fibrosis and consists mainly of zinc-calcium-dependent protein hydrolases [16-18]. It has been shown that the expression of MMP-2 in liver tissues of children with biliary atresia is significantly higher than that of normal children, and the expression of MMP-2 is enhanced with increasing liver fibrosis [19]. It indicates that the abnormal expression of MMP-2 is closely associated with liver fibrosis [20]. The above study shows that the effectiveness of hepatic hollow field anastomosis treatment is closely related to the age of the child, the degree of liver damage, and MMP-2. The treatment of surgery should be performed as early as possible to prevent the effect of treatment, and secondly, the degree of postoperative liver fibrosis should be paid close attention to, and the degree of liver fibrosis can be more accurately reflected by the detection of MMP-2 and other indicators.