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Biliary Atresia: A Meta-analysis of Indian Studies
Akshit Vats1, Alka Bhatia2, Yashwant Kumar1
1Department of Immunopathology, Post Graduate Institute of Medical Education & Research, Chandigarh, India.
Insights
Research on biliary atresia (BA) in India is limited. Future studies need multidisciplinary approaches to improve diagnosis, management, and outcomes for this neonatal cholestasis condition.
Area of Science:
- Pediatric Gastroenterology and Hepatology
- Systematic Review and Meta-Analysis
Background:
- Biliary atresia (BA) is a primary cause of neonatal cholestasis and a leading indication for pediatric liver transplantation (LT).
- Research on BA within the Indian subcontinent is historically sparse and fragmented, hindering comprehensive understanding and care.
Purpose of the Study:
- To systematically review and analyze existing research on biliary atresia in the Indian subcontinent.
- To identify research gaps and propose future directions for advancing BA understanding and management in India.
Main Methods:
- A systematic literature search was conducted using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
- 702 records were identified, with 64 eligible studies analyzed, focusing on clinical features, surgical outcomes (Kasai portoenterostomy), and short-term prognosis.
Main Results:
- Existing research predominantly focuses on clinical, radiological, and laboratory aspects, exhibiting considerable variability.
- Significant gaps exist in understanding BA's disease mechanisms, etiopathogenesis, and diagnostic advancements.
- Most studies examined clinical features, surgical outcomes after Kasai portoenterostomy, and short-term prognosis.
Conclusions:
- There is a critical need for more focused, conceptually driven, and collaborative research efforts on biliary atresia in India.
- Future research should integrate multidisciplinary approaches, including molecular, genetic, and public health perspectives, to address current knowledge gaps.
- India has the potential to establish a cohesive research framework for innovation in BA diagnosis, management, and long-term outcomes.
Abstract:
Biliary atresia (BA) is a leading cause of neonatal cholestasis and a major reason for pediatric liver transplantation (LT). Despite its clinical importance, research from the Indian subcontinent has historically been sparse and fragmented. Using a Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)-guided search, we identified 702 records and analyzed 64 eligible studies, most of which examined clinical features, surgical outcomes particularly after Kasai portoenterostomy, and short-term prognosis. Most existing research remains clinical, radiological, or laboratory based, with considerable variability across findings. Substantial gaps were noted, particularly in understanding disease mechanisms, etiopathogenesis, and diagnostic advancements. This highlights the need for more focused, conceptually driven, and collaborative efforts. To advance understanding and care of BA in the Indian context, future research must incorporate multidisciplinary approaches, including molecular, genetic, and public health perspectives. By building on the growing interest and solid clinical foundation, India is well positioned to develop a cohesive, forward-looking research framework that addresses current gaps and fosters innovation in the diagnosis, management, and long-term outcomes of BA.
