Delay of surgical treatment of biliary atresia.

Prognosis of extrahepatic biliary atresia depends on an early surgical trea tment. This survey studied the delay to surgery of infants treated for bili ary atresia and analysed the causes of late diagnosis and referral. Material and methods, - Medical files of 21 infants treated for biliary atr esia between 1988 and 1998 were retrospectively analysed. Results. - Median age at biliary operation was 57 days and did not change d uring time. In only 3/21 cases, surgery was performed before 45 days of age . The first clinical or biological sign of cholestasis was noted ata median age of 12 days. In eight cases, the first medical visit for cholestasis (m edian age of 21 days) was not followed by a blood test. In II cases, infant s presenting with biological cholestasis were referred to hospital more tha n seven days later. False diagnosis was noted in seven cases and delayed si gnificantly the operation. Conclusion. - The delay to surgical treatment is too long and does not decr ease whereas a majority of infants visit their physician early. Medical inf ormation is mandatory for all physicians taking care of infants. (C) 2001 E ditions scientifiques et medicales Elsevier SAS.