Extrahepatic biliary atresia. Recent developments in management.

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Abstract
The introduction of portoenterostomy has clearly increased the chances of long-term survival in infants with extensive destruction of the extrahepatic bile ducts, but this is still only achieved in a minority of patients. The chances of apparent cure are increased when the operation is performed before 60 days of age. Suspected cases should be referred to centers with the necessary expertise to make an early presumptive diagnosis and to assess the condition of the bile ducts at laparotomy. To withhold surgery until it is certain by laboratory tests and clinical course that the case is not one of neonatal hepatitis, and not in the best interests of the patient with suspected biliary atresia, be it noncorrectable, correctable, or even choledocal cyst, is suggested.