This calculator aims to early identify biliary atresia in cholestatic infants whose age less than 100 days, gestational age more than 34 weeks or birth weight more than 2000g.

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This is for your reference only, as peer review is ongoing
Items Value
Weight on admission
clay-colored stools
Abnormal gallbladder
GGT on admission
Total bilirubin on admission
Total bilirubin first repeated within 5-7 days following admission
Albumin on admission
Triangular cord sign
P =
Risk =
Subjects How to use Note Formula
Subjects Return to TOP
  • The algorithm was derived from 461 Chinese cholestatic infants (172 biliary atresia and 289 non-biliary atresia aged 2-97 days.
  • Cholestasis was defined as conjugated bilirubin >20% of the total bilirubin for total bilirubin of >85 mmol/L or >17 mmol/L for total bilirubin <85 mmol/L). Biliary atresia was confirmed by intraoperative cholangiography in combination with histological features of liver biopsies.
How to use Return to TOP
  • After enter measurements of weight on admission (Kg),
  • clay-colored stools (presence or absence),
  • abnormal gallbladder (presence or absence),
  • GGT on admission (U/L),
  • total bilirubin on admission (μmol/L or mg/dl),
  • total bilirubin first repeated within 5-7 days following admission (μmol/L or mg/dl),
  • albumin on admission (g/L),
  • triangular cord sign (presence or absence) ,
  • this calculator could estimate the probability of such infant having a biliary atresia, classify them into high-, intermediate-, and low-risk stratification and offer recommendations.
Note Return to TOP
  • Abnormal gallbladder (Ab-gallbladder) was defined as non-visualization of the gallbladder or gallbladder length ≤15 mm.
  • Triangular cord sign (TCS) was defined as the presence of an abnormal triangular or tubular echogenic area in the region of the porta hepatis.
  • ΔTBIL= first repeat total bilirubin within 5-7 days following admission- total bilirubin on admission.
  • Patients older than 100 days or gestational age <34 weeks or birth weight ≤2000g should be further evaluated by this calculator.
Formula Return to TOP
  • Ln (Odds of Biliary Atresia) = -3.5872 + 0.8644 * (Weight; kg) + 1.4572 * clay-colored stools + 1.8654 * Ab-gallbladder + 0.00317 * (GGT; u/L) + 0.0158 * (△TBIL; umol/L) - 0.0807 * (albumin; g/L) + 2.5456* TCS
Zhao et al. Web-based Calculator for Biliary Atresia Screening in Neonates and Infants with Cholestasis

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