Collection
Biliary Atresia
Also covers: 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
Prenatally diagnosed choledochal cysts require fetal consultation at a fetal surgery center for establishment of care and counseling, because cystic biliary atresia must be ruled out postnatally. — Alex Bondoc, Choledochal Cyst Podcast · 3:25
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
CD56 IHC stain is helpful as a complementary test in liver biopsies to rule out biliary atresia as an etiology for neonates presenting with cholestasis — Maria Soledad Jara Valdivia, BOB Ped Surg 2023 - Maria Soledad Jara Valdivia, CIPESUR - Presentation · 5:05
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
American Academy of Pediatrics recommends fractionation of bilirubin for any baby with persistent jaundice beyond two weeks of age, with referral to pediatric gastroenterologist if direct bilirubin is elevated — Jorge Bezerra, Biliary Atresia Part II · 1:50
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
A direct bilirubin greater than 20% of the total or greater than 1.0 prompts further workup for biliary atresia. — Jonathan Roach, Error Traps and Culture of Safety in Biliary Atresia · 0:40
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
For a hypotensive, tachycardic pediatric blunt trauma patient who has received 20 cc/kg crystalloid, the next steps should be early blood therapy and potentially massive transfusion protocol with balanced resuscitation, consistent with ATLS guidelines. Update Course 2021: UPDATE COURSE 2020: REVIEW OF LAST YEAR'S IMPORTANT T OPICS · 8:30
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
By two weeks of age, if the baby still has jaundice, the pediatrician needs to fractionate the bilirubin; if the direct or conjugated fraction is elevated, think about pathologic jaundice — Jorge Bezerra, Biliary Atresia - Clinical Practice Updates · 4:16
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
At Cincinnati Children's Hospital, HIDA scans are not routinely used because the 3-5 day phenobarbital loading period can delay intervention into a time period potentially detrimental to Kasai outcome. — Greg Tiao, Biliary Atresia · 5:41
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
Resection of a part of the liver may trigger an alternative pathway of stem cell proliferation for hepatic regeneration with reduced fibrosis and improved survival. — Shilpa Sharma, Prof. Shilpa Sharma - Best of the Best in Pediatric Surgery 2024 · 3:58
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
Featured picks for families are being prepared — the summaries above are written for you.
Expert statements from the recordings in this collection.
Clinical Characteristics and Prognosis of Biliary Atresia with Low Serum Matrix Metalloproteinase-7 Levels
The study was a retrospective cohort study conducted in China
The study included 329 patients with biliary atresia
40 of the 329 patients had low MMP-7 levels
Patients with low MMP-7 had significantly lower 3-month jaundice clearance
Patients with low MMP-7 had significantly lower 6-month jaundice clearance
Patients with low MMP-7 had significantly lower 1-year native liver survival
Measuring MMP-7 can help with prognosis in biliary atresia patients
MMP-7 measurement may in the future help with treatment of biliary atresia patients
Biliary Atresia: Where are we now? Advanced Practice Providers Pediatric...
Pathologic jaundice occurs in 1 in 2500 live births
Biliary atresia is a progressive, obliterative, idiopathic cholangiopathy with two forms: perinatal/postnatal (80-90%) and fetal/embryonic (10-20%)
Biliary atresia incidence ranges from 1 in 5000 in Taiwan, 1 in 8-10,000 in Japan, and 1 in 18,000 in the United States and Europe
More females than males are affected by biliary atresia
Seasonal clustering of biliary atresia cases suggests viruses or infectious processes may be triggers
Biliary atresia is lethal if untreated
If conjugated or direct bilirubin is greater than or equal to 2, the child needs closer evaluation
Cites a guideline7:59
Some babies with biliary atresia have normal ultrasounds
The gold standard for biliary atresia diagnosis is the intraoperative cholangiogram
Cites a guideline8:26
At Children's Hospital Los Angeles, babies are pre-treated with 5 days of phenobarbital before HIDA scan
Timing of diagnosis and Kasai procedure is extremely important, with the sweet spot being 6 to 8 weeks of age
A French study showed 23% of Kasai patients had their native liver 20 years post-Kasai
Factors affecting survival with native liver include age at Kasai, type of biliary atresia, liver histology (bridging fibrosis), and center caseload
In England, consolidating Kasai procedures to 3 centers increased success rates
At Children's Hospital Los Angeles, 6 to 12 biliary atresia cases are seen per year, considered a high rate
If cirrhosis is seen on liver biopsy or frozen section during intraoperative cholangiogram, the procedure is stopped and the patient is listed for transplant
Kasai procedures in older babies (3.5-4 months) can bridge patients to transplant at one year of age, though with complications including ascending cholangitis and frequent hospitalizations
Bigger babies at time of transplant have easier transplant procedures
Expert opinion21:24
Children's Hospital Los Angeles has a very large, possibly the largest, living donor liver transplant center in the country, offering an alternative to cadaveric transplant
Most centers put babies on antibiotic prophylaxis postoperatively until they are eating
Post-operative steroids for biliary atresia are unproven
At Children's Hospital Los Angeles, peripheral IV lines are used postoperatively rather than Broviacs, and babies are not sent home on IV antibiotics