Poor performance of noninvasive predictors of esophageal varices during primary prophylaxis surveillance in biliary atresia

This prospective cohort study of 72 biliary atresia patients demonstrates that noninvasive markers poorly predict significant esophageal varices during surveillance, with successful portoenterostomy patients showing later varix development and lower bleeding risk than failed cases. The findings suggest current noninvasive predictors cannot reliably guide endoscopy timing in primary prophylaxis protocols.