Prognostic factors determining the surgical interference of biliary atresia in Egyptian infants: single-center experience

Abstract Background Biliary atresia is associated with considerable morbidity, and it the most frequent indication for pediatric liver transplantation. Hepatic portoentostomy (HPE), Kasai procedure, used commonly as first line of treatment but its long-term efficacy still remains controversial. In this study we decided to illustrate perioperative clinical, biomarkers, histopathological, surgical parameters that may determine outcome in operated infants biliary within 5 years at our center national institute (NLI). We analyzed risks failure 100 BA, diagnosed treated from June 2012 2017. Infant included categorized into two groups according outcome, failed successful group. The was determined by clearance jaundice 6 months where total serum bilirubin ≤ 2 mg/dL. Both were compared laboratory, ultrasonographic, endoscopic detection bile, histopathological characteristics, excised remnant duct size, type interference. Results After interference, 33% those 67%. Younger age, lower preoperative GGT, delayed onset after weeks life, levels post-operative 1-month direct bilirubin, significantly ( P = 0.001, 0.041, 0.025, 0.001 respectively). Also gall bladder contractility, duodenal bile test, degree hepatic fibrosis, interference significant risk factors affecting BA 0.003, 0.037, 0.005, 0.024, 0.002 Conclusions age GGT level are good predictors better performance level. This high-priority transplant referral postoperatively.