Assessment of Inter-Observer Variability in the Histological Diagnosis of Infantile Cholestasis

Infants with cholestasis prior to 181 days of age present a challenging diagnostic problem of differentiation between an extra- and intra-hepatic location of the cholestatic process. This assessment is critical, since any evidence of obstruction essentially mandates surgical exploration. Extrahepatic biliary atresia (EHBA) is the most frequent cause of persistent unrelieved infant jaundice amenable to surgical correction. This is a retrospective multi-center pathology project, which will examine interobserver variability in the histological diagnosis of infantile cholestasis with the aim of establishing reliable histological criteria of extra-hepatic obstruction in infants.