Lee WS, Ong SY, Foo HW, Wong SY, Kong CX, Seah RB, Ng RT. Chronic liver disease is universal in children with biliary atresia living with native liver. World J Gastroenterol 2017; 23(43): 7776-7784 [PMID: 29209118 DOI: 10.3748/wjg.v23.i43.7776]
Corresponding Author of This Article
Way Seah Lee, MBBS, MD, FRCPCH, Professor, Department of Paediatrics, University Malaya Medical Centre, Kuala Lumpur 50603, Malaysia. leews@um.edu.my
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Observational Study
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Lee WS, Ong SY, Foo HW, Wong SY, Kong CX, Seah RB, Ng RT. Chronic liver disease is universal in children with biliary atresia living with native liver. World J Gastroenterol 2017; 23(43): 7776-7784 [PMID: 29209118 DOI: 10.3748/wjg.v23.i43.7776]
World J Gastroenterol. Nov 21, 2017; 23(43): 7776-7784 Published online Nov 21, 2017. doi: 10.3748/wjg.v23.i43.7776
Chronic liver disease is universal in children with biliary atresia living with native liver
Way Seah Lee, Sik Yong Ong, Hee Wei Foo, Shin Yee Wong, Chen Xi Kong, Ru Bin Seah, Ruey Terng Ng
Way Seah Lee, Sik Yong Ong, Hee Wei Foo, Shin Yee Wong, Chen Xi Kong, Ru Bin Seah, Ruey Terng Ng, Department of Paediatrics, University Malaya Medical Centre, Kuala Lumpur 59100, Malaysia
Way Seah Lee, Paediatrics and Child Health Research Group, University Malaya, Kuala Lumpur 50603, Malaysia
Author contributions: Lee WS and Ong SY conceived the concept of the present research; Ong SY, Foo HW, Kong CX, Seah RB and Ng RT collected the clinical data; Wong SY provided statistical analysis; Lee WS and Ong SY wrote the first draft; Lee WS provided critical analysis to the draft; Lee WS revised the final draft; All authors approved the final draft.
Supported by University Malaya High Impact Research (UM.C/625/HIR/MOHE/CHAN/13/1) from Ministry of Higher Education, Malaysia.
Institutional review board statement: The study was reviewed and approved by the University Malaya Medical Centre, Kuala Lumpur Medical Ethical Committee (MEC 902.15).
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrolment.
Conflict-of-interest statement: None of the authors has any potential conflict of interest to declare.
Correspondence to: Way Seah Lee, MBBS, MD, FRCPCH, Professor, Department of Paediatrics, University Malaya Medical Centre, Kuala Lumpur 50603, Malaysia. leews@um.edu.my
Telephone: +603-79492065 Fax: +603-79494704
Received: June 9, 2017 Peer-review started: June 10, 2017 First decision: July 13, 2017 Revised: August 3, 2017 Accepted: August 15, 2017 Article in press: August 15, 2017 Published online: November 21, 2017 Processing time: 164 Days and 18 Hours
Core Tip
Core tip: Previous study showed that more than 90% of children with biliary atresia (BA) surviving with native livers have clinical and laboratory evidence of chronic liver disease (CLD). In the present cohort, we found that 71% of patients with BA living with native livers had no clinical complications of CLD and 90% had normal liver synthetic function, only 2% had ideal medical outcome. Common medical complications encountered were cholangitis, portal hypertension and bleeding oesophageal varices. Portal hypertension and bleeding oesophageal varices were seen in 12% and 6% of children younger than 5 years of age. Medical surveillance in children with BA after Kasai surgery for medical complications should start even before 5 years of age.