New progress in the diagnosis of biliary atresia / 中华实用儿科临床杂志

ABSTRACT

Biliary atresia(BA)is an inflammatory cholangiopathy of infancy with progressive biliary prolifera-tion resulting in fibrosis and obstruction of extrahepatic and intrahepatic bile ducts,which mostly occurs in neonatal period. It is widely believed that the early diagnosis and timely surgical intervention(Kasai procedure within 60 days postpartum)of biliary atresia can lead to better prognosis for BA otherwise the poor prognosis would be caused,there-fore the biggest challenge is to make an accurate diagnosis at the early stage after birth. Recently some progresses have been achieved in the diagnosis of BA such as stool color card screening and serum bilirubin measurements. If the screen result is abnormal or manifestations appear,further physical and chemical examinations are required. Ultrasonography is considered as a non - invasive,cost - efficient,easy - operated primary method to diagnose or exclude BA. Other choices are magnetic resonance cholangiopancreatography,endoscopic retrograde cholangiopancreatography,duodenal tube test and dynamic examination of duodenal fluid and radionuclide hepatobiliary scanning. Intra - operative cholan-giogram and liver biopsy remain the gold standards for diagnosing biliary atresia. Although some biomarkers and exami-nations have been proved distinct and potential for diagnosis of biliary atresia,an individual and ideal method has not been acknowledged. To conclude,a well - coordinated multidisciplinary approach is required in the assessment of sus-pected cases of biliary atresia,multi - technique and method combination is the strategy and direction in early diagnosis of biliary atresia.