ArticlePediatric gastroenterology, hepatology & nutrition2026
Role of Liver Biopsy in Biliary Atresia: Impact of Histological Fibrosis on Kasai Portoenterostomy Outcomes and Decision Making.
Article in Pediatric gastroenterology, hepatology & nutrition, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Purpose: This study aimed to evaluate the effect of histological fibrosis on liver biopsy at presentation on the decision-making and outcomes of Kasai portoenterostomy (KPE), as well as the subsequent timing of liver transplantation. Methods: A retrospective, cross-sectional study of children <13 years old with biliary atresia (BA) seen at the Royal Hospital between January 2007 and December 2021. Results: Forty children were diagnosed with BA, of whom 31 (77.5%) underwent a liver biopsy, and 26 (65.0%) underwent KPE. Thirty children (96.8%) had either complete or impending cirrhosis. Eleven children (42.3%) who underwent KPE received a liver transplantation at a median age of 26 months (interquartile range [IQR]=33-34). Four children did not undergo KPE, and seven (50.0%) of these underwent liver transplantation at a median age of 22 months (IQR=13-25). The age of liver transplantation did not differ statistically between the KPE group and the primary liver transplantation group ( Conclusion: Of the 40 children with biliary atresia, 31 had a liver biopsy, with 30 (96.8%) exhibiting either complete or impending cirrhosis. Hepatic fibrosis did not impact the decision to perform KPE. The age of liver transplantation did not differ significantly between the KPE and non-KPE groups (median ages of 26 vs. 22 months,
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