Recent Trends in the Diagnosis and Management of Biliary Atresia in Developing Countries.
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Date
2015-10
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Abstract
Need and purpose of review: Biliary atresia is a progressive obstructive cholangiopathy and is fatal if left untreated within 2 years of life.
Delay in referral is because of difficulties in differentiating it from physiologic jaundice and identifying an abnormal stool color. This paper
presents an overview on the diagnosis and discusses the current strategies in the management of this disease in developing countries.
Methods: Articles were retrieved from the PubMed database using the terms ‘biliary atresia’, ‘Kasai portoenterostomy’ and ‘pediatric liver
transplantation’. Contents of the article are also based on personal experience of the authors.
Conclusion: A national screening program using stool color cards as part of standard care in the neonatal period will greatly improve
early detection of biliary atresia. Outcomes will improve if it is diagnosed at the earliest after birth, the child is referred to an experienced
pediatric hepatobiliary unit for evaluation, and undergoes an early Kasai procedure. If an early Kasai portoenterostomy is performed,
nearly half of all children survive into adolescence, and about one-third are likely to have a long-term, symptom-free life with normal liver
biochemistry. Sequential treatment combining Kasai as first line and liver transplantation as second line results in 90% survival for
children with biliary atresia.
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Keywords
Biliary atresia, Kasai portoenterostomy, Liver transplantation, Neonatal cholestasis
Citation
Ramachandran Priya, Safwan Mohamed, Reddy Mettu Srinivas, Rela Mohamed. Recent Trends in the Diagnosis and Management of Biliary Atresia in Developing Countries. Indian Pediatrics. 2015 Oct; 52(10): 871-879.