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Abstract
The cholestatic syndrome in infants constitutes one of the most important challenges of pcdiatric hepatology. Approximately 50% to 70% of the cholcstasis in infanls are caused by idiopathic neonatal hepatitis and extrahepatic biliary atresia (BA) with predominance of
the former.
Biliar}’ atresia is ch o 1 angi ode struc five disease of intra and extra hepatic portion of the biliary system which lead to cirrhosis and liver failure if not early treated and remains the commonest indications for liver transplantation in pcdiairic. The incidence of biliary atresia is higher in Japan and south Asia (1:9000) than in Europe and USA (1:15000).
Diagnosis of BA is confirmed at laparotomy. The diagnostic approach for the infant with cholestatic jaundice is to decide within few days whether a surgical exploration is indicated to confirm BA and to correct it. The diagnostic lools for this purpose should focus on the percutaneous liver biopsy and its histology, macroscopic liver, biliary tract morphology and galj bladder size after four hours fasting and after feeding h^ ultrasound and on bile secretion through Ihe biliary tree evaluated by hepatobiliary sdntigraphy or duodenal tube.