Early Exclusive Diagnosis of Biliary Atresia among Infants with Cholestasis

摘要: The persistence of jaundice beyond the first 2 weeks life require further investigation and this can be determined if conjugated bilirubin levels are greater than 1.5 mg/dL or 20% total level. There is a diverse differential diagnosis for cause neonatal cholestasis due to hepatobiliary disease including biliary atresia, which eventually leads liver cirrhosis uncorrected before 60∼80 days life. Long-established initial studies include abdominal ultrasonography, scintigraphy biopsy, but better diagnostic methods needed. Promising new options described MRCP (magnetic resonance cholangiography), ERCP (endoscopic retrograde PCC (percutaneous cholecysto-cholangiography). Though no single test differentiate atresia from other with confidence, combination usually consistently beneficial. By excluding as early possible, risk unnecessary explolaparotomy intraoperative cholangiography decreased. Further evaluation would required after atresia. (Korean J Pediatr Gastroenterol Nutr 2011; 14: 122∼129)