1ЭНЭШТ, 2ЭМШУИС
Objectives: To evaluate current diagnosis and treatment of biliary atresia.
Materials and methodology: Medical records of 34 patients with biliary atresia treated at Gastroenterolgy, Surgery and Neonatology units of MCHRC, Ulaanbaatar, Mongolia were retrospectively reviewed and compared with previous study (P. Otgonsaikhan et all) on «Diagnosis, treatment and control of biliary atresia» in 2001-2006.
Results: Biliary atresia was diagnosed in 32 cases during 2001-2006 and 34 cases during 2006-2009. In 2001-2006, 19 (59.3%) patients underwent a Kasai operation, 13 (40.6%) patients didn`t have operation. In 2006-2009, number of patients with Kasai increased to 26 (76.4%). We established that physical examination and biochemical tests were 100% sufficient to diagnosis biliary atresia. Other diagnostic methods include USG, cytomegalovirus and hepatitis serologic markers. The USG was used in 15 (46.8%) cases during 2001-2006 and 34 (100%) cases during 2006-2009. Hepatitis serological markers were used in 14 (43.7%) cases during 2001-2006 and 17 (50%) cases during 2006-2009. Diagnosis of cytomegaloviral infection was conducted in 12 (37.5%) cases during 2001-2006 and 19 (55.8%) cases during 2006-2009. The scintography was conducted in 32 (100%) cases during 2001-2006 and 20 (58%) cases during 2006-2009.
The age of biliary atresia diagnosis: If the biliary atresia was diagnosed within 60 days after birth in 14 (43.7%) cases during 2001-2006, it was diagnosed in 22 (64.7%) cases during 2006-2009. The diagnosis of biliary atresia after 60 days was established in 18 (56.2%) patients during 2001-2006 and reduced to 12 (35.2%) during 2006-2009. This shows that the diagnosis of biliary atresia is improving.
Conclusions: Although biliary atresia is diagnosed 100% through physical examination, blood biochemistry and USG, the diagnostic potencials of other current methods of diagnosis, such as hepatitis serological markers 50%, cytomegaloviral serological marker 55.8%, scintography 58%, CTG and MRI are not fully employed in Mongolia. Before 60 days of life the biliary atresia is diagnosed in 64.7% and surgical treatment is performed in 38.4% of cases.
