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vol.51 issue1ANALYSIS OF THE SURVIVAL OF CIRRHOTIC PATIENTS ENLISTED FOR LIVER TRANSPLANTATION IN THE PRE- AND POST-MELD ERA IN SOUTHERN BRAZILTESTOSTERONE CHANGES IN PATIENTS WITH LIVER CIRRHOSIS BEFORE AND AFTER ORTHOTOPIC LIVER TRANSPLANTATION AND ITS CORRELATION WITH MELD author indexsubject indexarticles search
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Arquivos de Gastroenterologia

Print version ISSN 0004-2803

Abstract

QUEIROZ, Thais Costa Nascentes et al. BILIARY ATRESIA: evaluation on two distinct periods at a reference pediatric service. Arq. Gastroenterol. [online]. 2014, vol.51, n.1, pp.53-58. ISSN 0004-2803.  http://dx.doi.org/10.1590/S0004-28032014000100011.

Context

Biliary atresia is a progressive, idiopathic, fibro-obliterative disease of the extrahepatic biliary tree that pre­sents with biliary obstruction exclusively in the neonatal period.

Objectives

To assess the differences regarding age at referral, age at surgery, duration of propaedeutics and waiting time for surgery between two groups of infants in different periods.

Methods

Retrospective study of infants diagnosed with biliary atresia on two periods: 1983-1993 and 1998-2011.

Results

Biliary atresia was diagnosed in 129 infants, being 48 in casuistic I and 81 in casuistic II. The median age at admission was 94 and 60 days, respectively (P = 0.0001). On evaluating patients who had undergone portoenterostomy before 120 days of age, no difference was observed regarding the duration of propaedeutics or waiting time for surgery (P = 0.15), but difference was found when comparing the age at surgery (P = 0.002). Among those infants with no biliary flow and without liver transplantation or death after 18 post-operative months, the estimated probability of survival was 44.6% and 38.7% in casuistics I and II, respectively. In casuistic I, all infants who showed biliary flow were alive during the observation period and, in casuistic II, 80.3% were alive after 7 years of follow-up.

Conclusions

Even though patients were admitted and treated earlier, it is clear that surgery could be done sooner. Delay in referral and timely propaedeutics were the main contributors.

Keywords : Biliary atresia; Hepatic portoenterostomy; Liver transplantation; Prognosis.

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