Analysis of health care delivery in patients with biliary atresia in a tertiary hospital in Northeast Brazil Avaliação da atenção em saúde em pacientes com atresia de vias biliares em um hospital terciário no Nordeste do Brasil

1. MD. Assistant Professor at Pernambuco Health Faculty (FPS). Pediatric Surgeon at Instituto de Medicina Integral Prof. Fernando Figueira (IMIP), Recife, PE. https://orcid.org/0000-0002-7801-175X. Email: rodrigogallindo@hotmail.com 2. MD. Physician. Pernambuco Health Faculty (FPS), Recife, PE. https://orcid.org/0000-0002-2141-526X. Email: calinesmedeiros@msn.com 3. MD. Physician. Pernambuco Health Faculty (FPS), Recife, PE. https://orcid.org/0000-0003-0047-4604. Email: eduardo_holanda_@hotmail.com 4. MD. Physician and Researcher. Pernambuco Health Faculty (FPS), Recife, PE. ORCID: Nogueira R -https://orcid.org/0000-0002-0238-8374. E-mail: raquelnogueiramd@gmail.com 5. MD. Research Associate, Department of Surgery, Montefiore Medical Center, The Bronx, New York, The United States. https://orcid.org/0000-0001-7383-1284. E-mail: dilaurentino@gmail.com 6. MD. Physician. Pernambuco Health Faculty (FPS), Recife, PE. https://orcid.org/0000-0002-1618-992. Email: melinafp@outlook.com Corresponding author: Diego Laurentino Lima. 1741 Seminole Avenue. The Bronx, Nova Iorque. 10461-1807 – Nova Iorque – EUA. Email: dilaurentino@ gmail.com ABSTRACT: Introduction: Biliary atresia (BA) is a rare pediatric disease, but it is the main cause of liver transplantation in children, if not reversed with the Roux-en-Y portoentorostomy (Kasai surgery) in adequate time. There is a tendency for the surgical procedure to be delayed throughout Brazil and an investigation of its cause is necessary. Objective: to determine the epidemiological profile of the patient with BA and to evaluate the health care focused on it at a tertiary hospital. Methods: a descriptive, retrospective, cross-sectional study was performed using medical records of patients with a diagnosis of BA followed up at a tertiary hospital between 1996 and 2015. Results: the initial sample had 72 patients, and only 52 patients had complete records available at the hospital. Twenty-six patients were included with mean age at admission of 87,9 days (± 57,9), the ultrasound (US) was performed in 24 cases, and it was repeated in ten cases. The Kasai surgery was performed in 50% of the patients, 38.4% of which during the appropriate time. Of the patients who were operated on later, 25% were transplanted and 50% died, while in the four operated on time, only one was transplanted and there were no deaths. Conclusion: the diagnostic difficulties, in particular, failure to suspect BA in primary or tertiary care, in addition to a falsenegative USG results, delayed the surgical procedure, confirming the worst outcome when the surgery was delayed.