A multicenter study on the diagnosis and treatment of biliary atresia in children

Abstract

Objective To evaluate the efficacy and safety of a standardized protocol for the diagnosis and treatment of biliary atresia (BA) in children.Methods This study enrolled 498 patients from 4 hospitals diagnosed with BA from January 2004 to December 2009.The BA patients of the standardized protocol group,who enrolled in this study after January 2007,were diagnosed and treated using the standardized protocol.The rest of the patients were taken as controls.The patients were followed up for 2 years.The age of the first diagnosis,the age at operation,jaundice clearance,the occurrence of cholangitis and two year survival rates with native liver were retrospectively reviewed and compared between the 2 groups.Results Among the 498 patients,456 patients underwent Kasai procedure.Age of the first diagnosis between the two groups showed no difference (33 ± 27 vs 34 ± 26 days,P＞0.05),but the patients of the standardized protocol group received surgeries at earlier ages (64 ± 24 vs 74 ± 31 days,P＜0.05).The jaundice clearance rates of 3,6 and 12 months after operation in the patients of the standardize protocol group were higher than those of controls (53.9%,56.9%,58.0% vs 38.9%,39.9%,43.4%,P＜0.05).Patients of the standard protocol group had lower occurrence of cholangitis (31.8% vs 47.8%,P＜0.05),and better two years survival rate (56.1% vs 39.3%,P＜0.05).Conclusions The standardized protocol for the diagnoses and treatment of BA improves the clinical outcomes of the children with BA. Key words: Biliary atresia; Multicenter study