What are the recommended management strategies for a neonate diagnosed with biliary atresia?

Recommended management strategies for a neonate diagnosed with biliary atresia focus on early diagnosis and prompt surgical intervention to improve outcomes. The primary treatment is the Kasai portoenterostomy, ideally performed before 8 weeks of age, to restore bile flow and prevent progressive liver damage ¹. Supportive care includes managing cholestasis symptoms, optimizing nutrition with fat-soluble vitamin supplementation, and monitoring for complications such as portal hypertension and liver failure ¹. If Kasai surgery is unsuccessful or if liver disease progresses, timely referral for liver transplantation is essential ¹. Recent literature emphasizes the importance of early detection through neonatal screening and suggests adjunct medical therapies to manage cholestasis, although these are not yet standard practice (Ramachandran et al., 2015; Heinz and Vittorio, 2023; Gorbatyuk and Kurylo, 2024). Multidisciplinary care involving paediatric surgeons, hepatologists, dietitians, and specialist nurses is critical to optimize long-term outcomes ¹.