Issn Print: 0277-2116

Publication Date: 1996/10/01


Print

50 LATE PRESENTATION AND SUCCESSFUL LATE SURGERY IN AFRICAN AMERICAN INFANTS WITH BILIARY ATRESIA

B Schoen; K Heiss; P Parker; K Sullivan; R. Ricketts

    loading  Checking for direct PDF access through Ovid

Excerpt

Biliary atresia is the progressive obliteration of the extrahepatic bile ducts in infancy. When untreated, the outcome is death, usually by 2 years of age. Kasai portoenterostomy can reestablish bile flow in selected infants, with best outcomes in infants under 60 days of age. Our center has had success in infants presenting beyond this age.
The purpose of this study is to assess preoperative factors which may predict successful outcome (postoperative clearance of jaundice) in late presenting infants.
We reviewed the medical records of all infants undergoing portoenterostomy between 1986 and 1996 at Egleston Children's Hospital. The following preoperative variables were assessed: gender, race, age at surgery, preoperative bilirubin, gamma glutamyl transpeptidase and alkaline phosphatase.
Twenty infants underwent portoenterostomy — 17 (85%) females. Thirteen infants were African American (65%). Twelve had surgery prior to 60 days of age with 6/12 (50%) success. Seven infants underwent surgery between 60 and 120 days with 5/7 (71%) success. Three infants had surgery between 90 and 120 days with 3/3 (100%) success. One infant operated after 120 days failed.
African American infants presented later than white infants — mean age at surgery 70 days (range 40-122) vs. 46 days (range 15-84) — but had equal surgical success — 7/13 (54%) vs. 4/7 (57%). All three infants operated between 90 and 120 days were black females. Lab variables were not predictive of outcome in our population.
African American infants with biliary atresia present later than their white counterparts and may have successful surgical outcomes as late as 120 days of age. Ongoing studies will further evaluate the causes of later presentation and factors contributing to late surgical success.
    loading  Loading Related Articles