Blocked Bile Duct & Gallbladder - How Surgery Can Be Of Help?

The Kasai procedure involves removal of the bile duct and gallbladder that are blocked and get them replaced with a segment of a child’s own small intestine. The segment of intestine gets sewed into the liver and hence functions as a new extrahepatic bile duct system.

A paediatric surgeon, who has specialized training in the management of surgically corrected problems in children, performs the operation. The surgeon carries out the operation through a laparoscope by making small incisions instead of a large one. He or she would determine the safest method of performing the operation and would discuss with the parents of a child before going ahead to conduct the surgery.

What are the possible outcomes after a kasai procedure?
Children, after having undergone the Kasai Procedure can come across the following outcomes, which include:

• Bile flow gets restored back to normal and recovery of liver function takes place in almost one third of children after Kasai Procedure.
• In the long-term, antibiotic therapy helps to reduce the risk of infection that enters the liver through the intestine.
• Though this procedure is not a permanent cure to get rid of biliary atresia, still in most of the cases, it allows patients to grow and stay healthy for a number of years.
• The children might not need liver transplantation.
• The remaining two thirds of children who have undergone this procedure won’t have sufficient bile flow as well as liver function, hence eventually requiring a liver transplantation.
• Out of this group of two-third children, half of them would soon require liver transplantation, whereas the other half would need it at a later date.
• When the surgery is done at an early stage, and the child is younger than 3 months old, close to 80 percent of the patients have some sort of bile flow.
• In almost 30 percent of those infants, sufficient bile gets drained out from the liver, which allows the bilirubin level to go back to normal.

Recovery process after the pperation
The recovery process for a child, who has undergone Kasai Procedure would include:

• A child would be cared for in the recovery area, so that one of the parents could be with him or her when they wake up.
• Then, from the recovery room, the child would be transferred to the paediatric floor and hence stay in the hospital for a few days.
• Then, once the child is able to eat properly, does not have any fever and feels comfortable to receive pain medication by mouth, he or she gets discharged and can get back home.
• Doctors give medications in order to prevent build-up of ascites or excess fluid.