Biliary atresia

Extrahepatic biliary atresia is a rare and highly morbid condition. When unrecognized, it progresses inexorably to liver failure and death unless liver transplantation is available. However, expeditious evaluation of the jaundiced infant that excludes other disorders and determines the biliary anatomy and function, employing nuclear, ultrasonographic, magnetic resonance, or other modalities, may lead to earlier referral for the appropriate operative intervention, the Kasai procedure. When successful, this procedure may delay or forestall the need for liver transplantation and its attendant morbidity. Improvements in the future may come from venues such as improved diagnostic techniques, determination of causes, better operative technique (including the application of robotics), and refinements in transplantation.