title: Pattern and survival of biliary atresia patients; experience in southern Nigeria.
abstract: BACKGROUND
  Biliary atresia (BA) has been a challenge to surgeons worldwide. Beyond the revolutionary surgical technique popularised by Kasai, liver transplantation has added renewed hope in the long-term outcome. In Nigeria, where late presentation is very common, there is need to assess the long-term results of the treatment options available to us.
  
  
  OBJECTIVE
  We aimed to evaluate the presentation and management outcome of BA and the long-term survival of BA patients seen in our practice.
  
  
  METHODS
  Cases of BA seen between January 2007 and December 2011 in three tertiary health facilities in South East Nigeria were included. Data obtained included age at presentation, clinical features, treatment offered and age at the time of death. Analysis was with the SPSS 17.0.
  
  
  RESULTS
  Twenty four patients comprising 10 (41.7%) males and 14 (58.3%) females were included in the study. The mean age of presentation was 4.02 (±214) months; range 1.75-11.0 months. Fifteen (62.5%) patients had surgery while 9 (37.5%) received medical treatment only. The mean age at death was 14.2 (±8.1) months; range 2.5-30 months.
  
  
  CONCLUSIONS
  BA poses a daunting challenge in our practice. Outcome of treatment is still discouraging. We identified late presentation, lack of facilities to make early diagnosis, lack of adequately trained manpower to manage these children and lack of post-operative care and support for patients as the major challenges in the management of BA children in our region.
authors.affiliation: Department of Surgery, Pediatric Surgery Unit, University of Port Harcourt Teaching Hospital, Port Harcourt, Orlu, Nigeria ; Department of Surgery, Pediatric Surgery Unit, Imo State University Teaching Hospital, Orlu, Nigeria ; Department of Surgery, Federal Medical Centre, Owerri, Imo State, University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria.
authors.forename: Philemon E
authors.initials: PE
authors.lastname: Okoro
authors.forename: Promise
authors.initials: P
authors.lastname: Igwe
authors.forename: Peace I
authors.initials: PI
authors.lastname: Opara
keywords: Atresia; biliary; pattern; surgical correction; survival
references.citation: Ann Trop Paediatr. 2007 Mar;27(1):69-73
references.pmid: 17469735
references.citation: Liver Transpl. 2009 Dec;15(12):1766-75
references.pmid: 19938121
references.citation: J Pediatr Surg. 1990 Apr;25(4):442-5
references.pmid: 2329462
references.citation: Pediatr Surg Int. 2000;16(5-6):351-5
references.pmid: 10955561
references.citation: Eur J Pediatr Surg. 2008 Apr;18(2):111-6
references.pmid: 18437656
references.citation: Zhonghua Wai Ke Za Zhi. 2008 Feb 1;46(3):173-5
references.pmid: 18683710
references.citation: Lancet. 2009 Nov 14;374(9702):1704-13
references.pmid: 19914515
references.citation: Tunis Med. 2008 Feb;86(2):128-35
references.pmid: 18444528
references.citation: Am J Surg. 2010 May;199(5):680-4
references.pmid: 20466116
references.citation: Transplant Proc. 2008 Oct;40(8):2534-6
references.pmid: 18929792
references.citation: J Pediatr Gastroenterol Nutr. 2010 Nov;51(5):631-4
references.pmid: 20818266
references.citation: Ann Trop Paediatr. 1987 Sep;7(3):200-4
references.pmid: 2445270
references.citation: Semin Pediatr Surg. 2008 May;17(2):116-22
references.pmid: 18395661
references.citation: J Pediatr Surg. 2009 Apr;44(4):695-701
references.pmid: 19361628
references.citation: Ann Hepatol. 2009 Apr-Jun;8(2):120-2
references.pmid: 19502654