Parameters that help to differentiate biliary atresia from other diseases

Background The diagnosis of biliary atresia (BA) is still challenging. The aim of this study was to analyze the clinical features and parameters that contribute to a diagnosis of BA. Methods From January 2000 to December 2013, 37 patients who underwent operative cholangiography were evaluated retrospectively. The patients were divided into two groups: a BA group, and a group with other cholestatic diseases (non-BA group). The demographic data and preoperative liver function test results were analyzed. Results Of the 37 patients, 29 patients were confirmed to have BA. The age at the time of the operation was not significantly different between the two groups (p=0.77). According to the results of the preoperative liver function tests, only the level of gamma-glutamyl transpeptidase (γ-GTP) was significantly higher in the BA group (p=0.015). The predominant non-BA disease was inspissated bile syndrome (IBS). In the IBS patients, the jaundice was relieved after lavage of the biliary tree. Conclusion The preoperative differentiation of infants with cholestasis is difficult based on laboratory data and imaging examinations. The preoperative level of γ-GTP may be useful for diagnosing BA; however, the operative cholangiography should be performed when the BA is suspected and cannot be ruled out by other methods, as the most common non-BA disease may be IBS. This article is protected by copyright. All rights reserved.