Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Dec 28, 2016; 8(36): 1593-1601
Published online Dec 28, 2016. doi: 10.4254/wjh.v8.i36.1593
Biliary atresia: Where do we stand now?
Krishna Kumar Govindarajan
Krishna Kumar Govindarajan, Department of Pediatric Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry 605006, India
Author contributions: The author solely contributed to this manuscript.
Conflict-of-interest statement: None.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Correspondence to: Dr. Krishna Kumar Govindarajan, Department of Pediatric Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry Road, Puducherry 605006, India.
Telephone: +91-413-2297328 Fax: +91-413-2297325
Received: April 3, 2016
Peer-review started: April 7, 2016
First decision: June 7, 2016
Revised: September 9, 2016
Accepted: November 1, 2016
Article in press: November 2, 2016
Published online: December 28, 2016

The pathway from clinical suspicion to establishing the diagnosis of biliary atresia in a child with jaundice is a daunting task. However, investigations available help to point towards the correct diagnosis in reasonable time frame. Imaging by Sonography has identified several parameters which can be of utility in the diagnostic work up. Comparison of Sonography with imaging by Nuclear medicine can bring out the significant differences and also help in appropriate imaging. The battery of Biochemical tests, available currently, enable better understanding of the line-up of investigations in a given child with neonatal cholestasis. Management protocols enable standardized care with optimal outcome. The place of surgical management in biliary atresia is undisputed, although Kasai procedure and primary liver transplantation have been pitted against each other. This article functions as a platform to bring forth the various dimensions of biliary atresia.

Keywords: Biliary atresia, Neonatal cholestasis, Kasai procedure, Neonatal jaundice, Hyperbilirubinemia

Core tip: The etiology of biliary atresia is intriguing with a myriad of diagnostics available to work up a child with neonatal jaundice. This article attempts to review the pathogenesis, evaluation, management and outcome for current update of biliary atresia.