Biliary Atresia
Also covered as: cholestasis · cirrhosis · choledochal cyst · jaundice · portal hypertension · Alagille syndrome · alpha-1 antitrypsin deficiency · ascites
Educational content from recorded physician discussions — not medical advice. Always talk to your child's care team about your child's situation.
Content of this collection
Fundamentals
3 items
Biliary Atresia: Where are we now? Advanced Practice Providers Pediatric...
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At the Advanced Practice Providers Pediatric Surgery Update Course in 2014, many distinguished advanced practice providers from around the world address the current evidence based management of the common pediatric surgical conditions. The
video48:21 · Jan 2019
Choledochal Cyst Podcast
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In this podcast, Dr. Alex Bondoc and Dr. Rae Hanke discuss the intricacies of choledochal cysts. Contributing editor: Dr. Rod Gerardo.Choledochal Cyst- Definition: Congenital cystic dilation of the biliary tree- Epidemiology: We
podcast22:07 · Dec 2020
Biliary Atresia with Dr. Greg Tiao
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Check out this week's episode with everything the surgical trainee needs to know about the work up, management, and types of biliary atresia with Dr. Greg Tiao from Cincinnati Children's Hospital.
video11:34 · Jun 2022
Diagnosis & Workup
3 items
Biliary Atresia Part I
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This podcast is a discussion of the international approach to diagnosis and management of biliary atresia, amongst Dr. Todd Ponsky, Dr. Yamataka Atsuyuki, Dr. Greg Tiao, Dr. Mark Davenport, and Dr. Jorge Bezerra.
In part one of this podcas
podcast31:15 · Oct 2022
BOB Ped Surg 2023 - Maria Soledad Jara Valdivia, CIPESUR - Presentation
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Watch Maria Soledad Jara Valdivia, MD, present her presentation on "The immunohistochemical staining CD56 is useful in the diagnosis of biliary atresia."
video · Feb 2023
Update Course Rewind: MMP-7 & Biliary Atresia Diagnosis 2024
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In this Update Course Rewind session, Dr. Greg Tiao, Surgical Director of the Liver Transplantation Program at Cincinnati Children’s, discusses the critical role of MMP-7 as a biomarker in the early diagnosis of biliary atresia. With data s
video6:24 · Mar 2025
Medical Management
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Biliary Atresia Part II
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This podcast is a discussion of the international approach to diagnosis and management of biliary atresia, amongst Dr. Todd Ponsky, Dr. Yamataka Atsuyuki, Dr. Greg Tiao, Dr. Mark Davenport, and Dr. Jorge Bezerra. In part two of this podcast
podcast42:23 · Oct 2022
Surgical Management
3 items
Biliary Atresia: Update Course 2015
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During the 3rd Annual Stay Current in Pediatric Surgery Update Course in 2015, Dr. Greg M. Tiao, Chief of Pediatric Surgery at Cincinnati Children's Hospital, discusses biliary atresia. Dr. Tiao covers topics on cholestasis in infants, diag
video20:34 · Jan 2019
Error Traps and Culture of Safety in Biliary Atresia
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This video highlights a few key points from the "Error Traps and Culture of Safety in Biliary Atresia" article published in Seminars in Pediatric Surgery, provided by lead author Dr. Jonathan Roach. Find the full article at: www.sciencedire
video4:32 · Nov 2019
Heat 1 Winner: Dariusz Patkowski, MD, PhD - Best of the Best in Pediatric Surgery 2024
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Watch the voting from the first heat!
Presentations from heat one:
Prof. Shilpa Sharma: Exploring alternative pathway of stem cell proliferation for hepatic regeneration by partial liver resection in extra hepatic biliary atresia.
video2:30 · Feb 2024
Evidence & Research
11 items
Biliary Atresia, Appendicitis, Intestinal Failure, and Anesthetic...
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Audio Journal with Dr. Von Allmen about usingCorticosteroids After Hepatoportoenterostomy for Bile Drainage, Dr. Whit Holcomb aboutsurgical site infections (SSI) are an important source of morbidity and mortality.andfeasibility and safety o
podcast44:19 · Jan 2019
Biliary Atresia, Appendicitis, Intestinal Failure, and Anesthetic...
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Audio Journal with Dr. Von Allmen about using Corticosteroids After Hepatoportoenterostomy for Bile Drainage, Dr. Whit Holcomb about surgical site infections (SSI) are an important source of morbidity and mortality. and feasibility and safe
podcast44:19 · Dec 2020
Update Course 2021: UPDATE COURSE 2020: REVIEW OF LAST YEAR'S IMPORTANT T OPICS
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General surgery residentRodrigo Gerardo, MD reviews the highlights from the 2020 Update Course including MMP7 for diagnosing biliary atresia, complex gastroschisis, and so much more.
video23:20 · May 2022
Quick Literature Updates Episode 9
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We’re back with ninth episode of "Quick Literature Updates" the podcast series that delivers the latest updates in pediatric surgery literature in a quick and digestible format. In each episode, we review four articles covering the most int
video · Jun 2023
Heat 3 Winner: Shruthi Srinivas, MD - Best of the Best in Pediatric Surgery 2024
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Watch the voting from the third heat!
Presentations from heat three:
Mina Yeganeh, BSc: Lipid nanoparticle delivery of miRNA-148a attenuates intestinal inflammation during experimental.
Joseph Davidson, MA(Oxon), MBBS, MRCS(Eng)
video1:47 · Feb 2024
Jingying Jiang, MD - Best of the Best in Pediatric Surgery 2024
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Watch PAPS' Dr. Jingying Jiang’s presentation on “Clinical characteristics and prognosis of biliary atresia with low serum matrix metalloproteinase-7 levels.” at the 2024 Best of the Best in Pediatric Surgery event!
Moderators: Todd Pons
video6:58 · Feb 2024
Clinical Characteristics and Prognosis of Biliary Atresia with Low Serum Matrix Metalloproteinase-7 Levels
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New Article you should know by Dr. Cecilia Gigena from Journal of Pediatric Surgery.
"Clinical Characteristics and Prognosis of Biliary Atresia with Low Serum Matrix Metalloproteinase-7 Levels"
Authors: Jingying Jiang, Yifan Yang, Xue
video0:55 · Jul 2024
Características clínicas y pronóstico de la atresia de vías biliares con niveles bajos de metaloproteinasa 7 de la matriz sérica
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Nuevo artículo que tienes que conocer por la Dra. Cecilia Gigena del JPS
"Características clínicas y pronóstico de la atresia de vías biliares con niveles bajos de metaloproteinasa 7 de la matriz sérica"
Autores: Jingying Jiang, Yifa
video0:55 · Jul 2024
Journal of Pediatric Surgery Article Review: 2nd Quarter (Apr-Jun) 2024
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We are back with another episode of our Journal of Pediatric Surgery article review podcast. This time we have three publications from the second quarter of 2024, April, May, and June issues. This time we're talking to editors Drs. Mary Bri
podcast17:03 · Sep 2024
Update Course Rewind: 2024 Top Ten Key Takeaways
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Join us for a highlight reel of the Top 10 Key Takeaways from the 12th Annual Update Course in Pediatric Surgery. This session covers the latest advances, practical tools, and emerging trends that are shaping the future of pediatric surgica
video18:01 · Jun 2025
Update Course Rewind: 2024 Top Ten Key Takeaways
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Update Course Rewind: 2024 Top Ten Key Takeaways | Podcast Episode on RSS.com Sign up free Features Resources Pricing Podcasts Sign up free Sign In Stay Current in Pediatric Surgery... Update Course Rewind: 2024 Top Te... Update Course Rewi
podcast18:01 · Jul 2026
Case-Based Learning
3 items
Biliary Atresia - Robert Parry: Update Course 2014
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Dr. Robert Parry, Director of Pediatric Surgery, Akron Children's Hospital, presents a clinical case of biliary atresia diagnosis. Topics discussed include kasai procedure, HIDA scan for biliary atresia, postoperative corticosteroids, and r
video24:55 · Nov 2018
Biliary Atresia-Case Presentation and Panel Discussion: Update Course 2014
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During the 2ndAnnual Stay Current in Pediatric Surgery Update Course in 2014, Dr. Robert Parry, Director of Pediatric Surgery, Akron Children's Hospital, and Dr. Nick Bruns present a clinical case of biliary atresia diagnosis. Topics discus
video23:47 · Jan 2019
Biliary Atresia - Clinical Practice Updates
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This clip from the 2020 Pediatric Surgery Update Course features Alexander Bondoc, MD, presenting multiple cases and research conclusions from Atsuyuki Yamataka, MD; Greg Tiao, MD; Jorge Bezerra, MD; and Mark Davenport, MD, to our selected
video · Sep 2020
In-Depth Reviews
1 item
Biliary Atresia
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Dr. Greg M. Tiao, Chief of Pediatric Surgery at Cincinnati Children's Hospital, discusses biliary atresia. Dr. Tiao covers topics on cholestasis in infants, diagnosis imaging in cholestatic infant, liver biopsy, biliary atresia extended dis
video20:57 · Jan 2019
Emerging & Future Directions
1 item
Prof. Shilpa Sharma - Best of the Best in Pediatric Surgery 2024
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Watch WOFAPS' Prof. Shilpa Sharma's presentation on "Exploring alternative pathway of stem cell proliferation for hepatic regeneration by partial liver resection in extra hepatic biliary atresia" at the 2024 Best of the Best in Pediatric Su
video5:46 · Feb 2024
Summaries and takeaways+ Show
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Every expert statement below comes from the recorded discussions, with its speaker and moment.
Biliary Atresia-Case Presentation and Panel Discussion: Update Course 2014
French registry data show significantly better 5- and 10-year native liver survival when Kasai performed before 30 days versus after 90 days, with nearly twice the survival rate
clinical2:44 ↗
In a Michigan series, children who had Kasai after 3 months had the best drainage and long-term outcomes
clinical1:03 ↗
Under 60 days there was a clear difference in outcomes; procedures done on weekends if approaching day 60
clinical1:50 ↗
The critical factor determining outcome is the degree of cirrhosis developed in the liver, which varies among children and does not always correlate directly with age
clinical3:24 ↗
Biliary atresia does not start at day zero in all patients; some may begin at day 20 and progress from there
clinical3:53 ↗
A series from Rich Ricketts showed not statistically significant better results with Kasai performed at 76 days or older versus 0-75 days
clinical4:03 ↗
Peter Altman from Columbia, who had the largest US series, argued Kasai should be done between 60 and 75 days
opinion5:57 ↗
Reversal of portal flow is very concerning because patients can achieve good biliary drainage and normal bilirubin but portal hypertension continues to progress, leading to transplant need
clinical9:19 ↗
Performing Kasai can buy time and increase the donor pool potential, even if the liver looks horrible
clinical10:05 ↗
Transplant becomes technically easier in older children with lower risk of hepatic artery thrombosis
clinical10:27 ↗
Hepatologists can manage biliary atresia patients medically for about a year in the absence of Kasai or transplant, though nutritional status is not optimal
clinical10:41 ↗
If patients have signs of end-stage liver disease with profound fibrosis and reversal of portal flow, Kasai may not improve outcomes and the operation may stress them unnecessarily
opinion10:56 ↗
The Kasai operation itself is not technically demanding with low technical risk, so if uncertain, redo procedures are reasonable
opinion11:44 ↗
Some biliary atresia cases show a race between hepatocyte regeneration and fibrosis progression; one patient's bilirubin dropped to normal 5 months post-op
clinical12:20 ↗
If liver biopsy is suggestive of biliary atresia, additional testing is not needed
opinion14:02 ↗
HIDA scan with phenobarbital has high sensitivity and specificity for biliary atresia
clinical15:21 ↗
An effective HIDA requires at least 5 days of phenobarbital at therapeutic levels
clinical15:47 ↗
In cases where initial HIDA without adequate phenobarbital was negative, about one-third showed biliary atresia when repeated with proper phenobarbital levels
clinical16:40 ↗
A recent paper in Gastroenterology showed a scoring system combining liver biopsy with clinical parameters had almost 100% ability to predict biliary atresia
clinical17:35 ↗
Pathologists' understanding of what to look for in biliary atresia biopsies has improved compared to 20 years ago
clinical18:01 ↗
Interventional radiologists can perform percutaneous liver biopsies safely and routinely
clinical18:10 ↗
Patent gallbladder in true biliary atresia is super rare
clinical18:41 ↗
In Milwaukee, percutaneous cholangiography combined with biopsy can quickly provide answers when successful
clinical18:59 ↗
If percutaneous cholangiography shows contrast in the gallbladder and bowel, biliary atresia is ruled out without need for surgery
clinical19:49 ↗
Prenatal ultrasound diagnosis of biliary atresia based on absent gallbladder is unreliable and angle-dependent
clinical20:44 ↗
Japanese centers still recommend steroids either routinely or when drainage decreases after Kasai
clinical21:46 ↗
Japanese surgeons now perform Kasai with wider porta dissection than Dr. Kasai originally did
clinical22:15 ↗
Japanese technique uses more superficial sutures to avoid damaging ductules and avoids placing sutures at 10 o'clock and 3 o'clock positions where normal bile ducts bifurcate
clinical22:39 ↗
Japanese centers claim better results with modified technique, though numbers are not statistically valid
clinical23:06 ↗
Yamataka is attempting to show laparoscopic Kasai results are as good as open, contrary to IPEG recommendations
clinical23:08 ↗
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