Diagnosis and treatment of biliary atresia: a retrospective study

BACKGROUND: Biliary atresia (BA) is the end results of an inflammatory process, which affect the intrahepatic and extrahepatic bile ducts, leading to fibrosis and obliteration of the biliary tract with the development of biliary cirrho- sis. Early diagnosis of BA is difficult, and there is no speci- fic therapy for BA at present. The purpose of this study was to investigate the diagnosis, treatment and postoperative outcome of BA and to explore new diagnostic and thera- peutic strategies. METHODS; Thirty-one children with biliary atresia from our hospital and 201 children with such disease from other hospitals in China were reviewed retrospectively in terms of diagnostic modalities, operative age, operative methods and long-term survival rates after operation. RESULTS : The operative age of the 31 patients varied from 13 to 270 days. It was <60 days in 6 children (19% ), 61-90 days in 14 (45% ), 91-120 days in 8 (26% ), and >120 days in 3 ( 10% ). No children underwent transplantation for BA. Their 1-6 year survival rate on average was 32. 3% (10/31). The early operative rate in China was 12.9% (30/ 232). One child received liver transplantation with a long- term survival rate of 31.9%. CONCLUSIONS; Early recognition of babies with BA is critical for optimal intervention for preventing progressive fibrosis. Clinical presentation, imaging and laparoscopy are helpful in enhancing the early diagnostic rate of BA pa- tients. The long-term survival rates can be obtained after the improvement of operative methods, liver transplanta- tion for children with advanced BA, and development of other medical strategies.