Biliary atresia is a congenital disease that occurs with lesions of the bile ducts leading to the development of cholestasis and manifests in the neonatal period. Without timely surgical treatment, patients with this pathology die during the first year of liver failure, esophagus bleeding or infections.
The objective of the research was to analyze the results of examinations and treatment of 21 children with biliary atresia who were treated at the surgical department of conformational abnormalities in children in Lviv City Children’s Clinical Hospital since 2008 to 2015.
Methods of the research included follow-up, laboratory ones, duodenal intubation, ultrasound, scintigraphy, MRI, diagnostic laparoscopy, liver paracentesis, determination of hepatitis B and C markers, DNA of CMV virus.
Results of the research. Among the examined children biliary atresia was diagnosed in 18 patients at the age under 2 months. All children were operated timely. 6 patients needed liver transplantation. Diagnosis was made in 3 children under the age of 3 months. The Kasai onoperat was conducted in 2 children. All 3 children needed liver transplantation. Children with satisfactory quality of life after liver transplantation are on permanent immunosuppressive therapy. They have signs of biliary cirrhosis and undergo periodically inpatient treatment of an ascending cholangitis.
Maintenance of normal nutritional (food) status, biliary tract patency and prevention of cholangitis and infections are the primary task in the course of postoperative treatment (The Kasai procedure).
Conclusions. Early diagnosis of biliary atresia and timely conducted surgical treatment (under 2 months of age) makes it possible to improve the prognosis, neurological status, quality of life and to prevent the necessity of liver transplantation at an early age.
Dehtyareva AV, Kulikova NV, Razumkovskyy AY, et al. Age-specific time course of changes in the clinical and laboratory manifestations of biliary atresia in children. Rossiyskiy vestnik perinatologiyi i pediatriyi. 2013; 58 (2): 17-23.
Savvina VA, Varfolomeev AR, Nikolaev VN, et al. Biliary therapy as the cause of neonatal cholestasis. Detskaya khirurgiya. 2013; 4: 25-28.
Giannattassio A, Cirillo F, Liccardo D, et al. Diagnostic Role for biliary atresia. Radiology. 2008; 247 (3): 912-913. http://dx.doi.org/10.1148/radiol.2473071715
Kasai M. Treatment of biliary atresia with special reference to hepatic portoenterostomy and its modifications. Progr Pediatr Surg. 1974; 6: 5-52.
Shi-Xing Li, Yao Zhandg, Mei Sun et al. Ultrasonic diagnosis of biliary atresia: a retrospective analysis of 20 patients. World J Gastroenterol. 2008; 14 (22): 3579-3582. http://dx.doi.org/10.3748/wjg.14.3579
Humphrey TM, Stringer MD. Biliary atresia: US diagnosis. Radiology. 2007; 244: 845 – 851. http://dx.doi.org/10.1148/radiol.2443061051
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