Perioperative Developments in Biliary Atresia Treatment

Purpose of Review This paper presents an overview of the current developments in the perioperative biliary atresia (BA) treatment. Recent Findings Biliary atresia is a rare cholangiopathy and the most common indication for pediatric liver transplantation. Kasai portoenterostomy is the primary therapy, leading to sufficient biliary drainage in 20-30% of patients with native liver. Multiple strategies in preoperative, operative, and postoperative care were tested to improve survival with native liver (SNL). Screening methods, centralization of care to specialized centers, laparoscopic Kasai procedure, and adjuvant steroid therapies are suggested to improve the operative outcomes. Summary There is no evident superiority of laparoscopic KPE nor adjuvant steroid therapy. However, screening programs and centralization of care to specialized centers are endorsed.