Treatment

Kasai Procedure

Overview

The Kasai procedure is also called hepatoportoenterostomy. It is a surgical treatment for biliary atresia, a rare liver condition in newborns. In biliary atresia, the bile ducts that drain bile from the liver are either missing or blocked, leading to liver damage. The Kasai surgery helps create a new pathway for bile to flow from the liver to the intestines, preventing further damage. This procedure is most effective when performed early, ideally within the first 8 weeks of life.

Why Kasai Procedure is Required?

Doctors recommend the Kasai procedure for biliary atresia because, without treatment, bile cannot drain from the liver, leading to:

• Liver damage and cirrhosis (permanent scarring of the liver).
• Jaundice (yellowing of the skin and eyes) due to bile buildup.
• Malnutrition because bile helps in digestion.
• Liver failure, making a liver transplant necessary.

Key Advantages of Kasai Procedure

• Restores bile flow, reducing jaundice and liver damage.
• Delays or prevents liver transplant in many babies.
• Improves quality of life by allowing the baby to grow and develop normally.
• Higher success rates if performed early (before 60 days of age).
• Less complex than a liver transplant, making it a preferred biliary atresia treatment.

How Should You Prepare Yourself Before Taking Kasai Procedure Treatment?

• Diagnosis confirmation: The doctor will conduct tests like ultrasound, liver biopsy and cholangiogram to confirm biliary atresia.
• Pre-surgery health optimisation: Proper nutrition and vitamins may be needed to strengthen the baby before surgery.
• Hospital stay preparation: Parents should be prepared for a few days of hospital stay post-surgery.

How Kasai Procedure is Performed?

• General anesthesia is given to ensure the baby does not feel pain.
• A small incision is made in the abdomen to access the liver.
• The blocked bile ducts are removed.
• A section of the small intestine is connected directly to the liver to allow bile drainage.
• The area is closed and the baby is monitored in a recovery unit.

What You Can Expect?

1. Before Procedure:

• Your baby may need intravenous (IV) fluids before surgery.
• Feeding may be stopped a few hours before the operation.
• The medical team will explain the procedure and potential risks.

2. During Procedure:

• The surgery takes 4-6 hours.
• The baby will be under general anesthesia so they would not feel pain.
• A small Kasai procedure scar may remain on the abdomen.

3. After Procedure:

• Hospital stay of about a week is needed for recovery.
• The baby will be monitored for jaundice improvement.
• Antibiotics and medications will be given to prevent infections.
• Special dietary support may be required for proper digestion.

Risk and Potential Complications

Like any surgery, the Kasai procedure has risks, including:

• Infections at the surgical site.
• Cholangitis (infection of bile ducts), requiring antibiotics.
• Scarring and bile flow issues, which may lead to Kasai procedure failure.
• Liver damage over time, leading to a need for a liver transplant.

Results/Outcomes

• Restores Bile Flow: Helps in reducing jaundice and improves digestion.
• Delays or Prevents Liver Transplant: Many children can live for years without needing a liver transplant.
• Higher Success with Early Surgery: Best outcomes if done before 60 days of birth.
• Improves Growth & Development: Supports better nutrition and overall health.
• Requires Lifelong Monitoring: Regular check-ups ensure liver health stays on track.
• May Not Be a Permanent Solution: Some children may still need a liver transplant later in life.
• Better Quality of Life: With proper care, many children grow up to lead healthy and active lives.