BILIARY ATRESIA: CURRENT CONCEPTS AND FUTURE PROSPECTS (REVIEW)

Area of Science:

• Pediatric Surgery
• Gastroenterology
• Biomedical Engineering

Background:

• Biliary atresia treatment is a significant challenge in pediatric surgery, with the Kasai procedure offering improved outcomes but not fully restoring biliary tract integrity.
• The Kasai procedure's limitations, such as the exclusion of the sphincter of Oddi, lead to intestinal content reflux, recurrent cholangitis, and increased cholangiocarcinoma risk.
• Current methods to prevent reflux and restore the hepaticocholedochus using biological or synthetic grafts have not achieved widespread clinical implementation.

Purpose of the Study:

• To review the challenges in biliary atresia treatment.
• To explore the limitations of the Kasai procedure and current reconstructive methods.
• To highlight the potential of organ and tissue bioengineering in developing novel solutions for biliary atresia.

Main Methods:

• Literature review of existing treatments for biliary atresia.
• Analysis of the complications associated with the Kasai procedure.
• Exploration of advancements in tissue bioengineering for biliary tract reconstruction.

Main Results:

• The Kasai procedure, while beneficial, does not fully address anatomical defects leading to complications.
• Various graft materials and anti-reflux techniques have been explored but lack clinical adoption.
• Tissue bioengineering presents a promising frontier for creating functional bile duct equivalents.

Conclusions:

• Current surgical interventions for biliary atresia have limitations that necessitate further innovation.
• Organ and tissue bioengineering advancements hold significant potential for developing improved bile duct replacements.
• Future research in bioengineered bile duct equivalents could revolutionize the treatment of biliary atresia.