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2022, Number 3

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Acta Pediatr Mex 2022; 43 (3)

Causes of death in children with surgical treatment for biliary. Autopsy study

Corcuera-Delgado CT, Ridaura-Sanz C

Language: Spanish
References: 26
Page: 147-155
PDF size: 296.61 Kb.


ABSTRACT

Background: Biliary atresia is an inflammatory fibrosing cholangiopathy leading to obstruction of bile flow and destruction of bile ducts. Surgical derivation is imperative to circumvent the obstruction and reestablish bile flow, otherwise the natural progression of the disease leads to fatal, irreversible liver damage. Surgical success and survival depend on the type of atresia, the particular segment obstructed, the age at which surgical correction was carried out and on postoperative clinical oversight.
Objective: To describe the causes of death in patients surgically treated for biliary atresia.
Material and Methods: This is a retrospective study of 15 autopsy cases of patients naundergoing corrective surgery for biliary atresia between 1971 and 2020, collected from the files of the Department of Pathology at the National Institute of Pediatrics in Mexico City. They were classified according to primary disease, contributing diseases and complications and compared in terms of type of atresia (perinatal vs fetal), anatomic type (correctable vs noncorrectable) and they were compared with those of 25 non-operated cases of biliary atresia.
Results: Perinatal biliary atresia was the predominant form (12/15), as was the noncorrectible form of atresia (13/15). Thirteen of our patients died as a consequence of biliary atresia and in two cases of the fetal form death ensued from congenital heart disease. Children operated on before the age of 2 months had a longer postoperative survival. Cholangitis was an important complication in patients undergoing surgery.
Conclusions: Risk factors involved in the success of treatment were delayed surgery and surgery in cases of fetal atresia. Cholangitis is a serious complication in surgical patients.


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