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 cirrhosis. Early diagnosis of BA is difficult, and there is no specific 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 therapeutic 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 patients. The long-term survival rates can be obtained after the improvement of operative methods, liver transplantation for children with advanced BA, and development of other medical strategies.
Tang
Shao-Tao
ST
Department of Pediatric Surgery, Wuhan Union Hospital, Huazhong Science and Technology University, Wuhan 430022, China. tshaotao83@hotmail.com
Ruan
Qing-Lan
QL
Cao
Zhi-Qing
ZQ
Mao
Yong-Zhong
YZ
Wang
Yong
Y
Li
Shi-Wang
SW
D001656:Biliary Atresia / Q000175:diagnosis* / Q000401:mortality / Q000601:surgery*; D002675:Child, Preschool; D002763:Cholecystectomy / Q000379:methods; D015331:Cohort Studies; D003952:Diagnostic Imaging / Q000379:methods*; D005260:Female; D006801:Humans; D007223:Infant; D010535:Laparoscopy; D016031:Liver Transplantation / Q000379:methods; D008297:Male; D011171:Portoenterostomy, Hepatic / Q000379:methods*; D011379:Prognosis; D011877:Radionuclide Imaging; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D015996:Survival Rate; D016896:Treatment Outcome; D018608:Ultrasonography, Doppler