Comportamiento clínico-quirúrgico en pacientes con atresia de vías biliares atendidos en el Hospital de niños Roberto Gilbert Elizalde de enero 2014 a enero 2025.

Abstract

Backround: Biliary tract atresia is the most frequent cause of cirrhosis and liver transplantation in neonates and infants. Prognosis depends on early diagnosis and intervention by Kasai portoenterostomy (KAP) or liver transplantation. Aim: To describe the clinical, demographic, surgical and mortality characteristics of patients with AVB treated at the Roberto Gilbert Elizalde children’s hospital, between January 2014-January 2025. Methods: Retrospective cross sectional descriptive study. The medical records of all infants with histological diagnosis of AVB were reviewed. Demographic variables, clinical laboratory and imaging findings, as well as PEK data in relation to failure and need for transplantation were obtained. Results: Forty-two patients were identified. Sixty-seven percent were women and the average age at diagnosis was 2 months. At admission, 40% presented with liver failure and cirrhosis. Twenty-seven infants (64%) had a history of PEK and was most frequently performed at 2 months of age. Among the 27 PEKs evaluated, the efficacy rate was 58%. Most patients required transplantation, but only 5 were transplanted during the study period. Overall mortality attributable to AVB was 19%, where cholangitis and portal hypertension were the most common postoperative complications. Conclusions: Most cases were diagnosed and intervened after the time recommended by international guidelines and studies. The findings underline the urgency of national neonatal screening strategies for early referral to PEK and to improve the efficacy of the procedure as well as the preservation of the native liver.