WOFAPS 2025 8th World Congress of Pediatric Surgery

Laura Camila González-Villarreal ¹, Edgar Salamanca-Gallo ², Santiago Correa-Salazar ², Felipe Ordoñez-Guerrero ²

¹ National University of Colombia
² Fundación Cardioinfantil (FCI) - Lacardio

Objectives: The cystic variant of biliary atresia (CBA) accounts for 5% to 10% of all cases. Although traditionally considered a condition with a more favorable prognosis, outcomes depend on the patient's age at the time of surgical diversion. This study aims to characterise outcomes of CBA patients at a high-volume center in our country.

Materials and methods: We conducted a retrospective observational study and case series report of patients diagnosed with cystic biliary atresia between 2020 and 2024 at Fundación Cardioinfantil (Bogotá, Colombia). Demographic, clinical, and therapeutic variables were assessed, along with patient outcomes. Disease progression was analysed on a case-by-case basis.

Results: A total of five female patients were included. In addition to jaundice and acholic stools, initial presentations involved biliary ascites and a presumed retroperitoneal neoplasm with abdominal compartment syndrome. The mean TB at admission was 6.03 mg/dL (SD 2.06 mg/dL), while the mean DB was 3.33 mg/dL (SD 1.68 mg/dL). The average cyst diameter was 28 mm (SD 11.1). The median age at KPE was 29 days (14-67 days). Jaundice clearance was achieved within six months. No patients required liver transplantation or died during follow-up.

Conclusions: This report is the first case series describing the management of cystic biliary atresia in Colombia. Our findings highlight the challenges of managing rare diseases in resource-limited settings. We conclude that the presence of a hepatic hilar cyst in a jaundiced newborn should be presumed to be CBA until proven otherwise.