The liver has ducts, so that the bile it produces can drain into the intestine and help with digestion of food. If these ducts are blocked, the Kasai procedure is a way to surgically bypass them and prevent liver damage. It is often the preferred treatment for biliary atresia. This procedure is named after Dr. Morio Kasai, the Japanese surgeon who developed it in 1951.
To perform the Kasai procedure, surgeons first carefully remove the damaged ducts outside of the liver. They use a small segment of the patient's own intestine to replace the ducts at the spot where bile is expected to drain. This segment not only connects to the liver, but also connects to the rest of the intestine. The Y-shaped passageway formed by the Kasai procedure allows bile to flow from the liver into the intestine.
If your child needs a Kasai procedure, he or she will usually spend seven to ten days recovering in the hospital. During this time, the Kasai will heal, and doctors will give your child medications to prevent ascites, or excessive fluid build-up. In the long-term, antibiotic therapy helps reduce the risk of infection entering the liver through the intestine. Although Kasai procedure is not a permanent cure for biliary atresia, in many cases it allows patients to grow and remain in good health for several years. This delays (or in about 25% of children, eliminates) the need for a liver transplant. When the Kasai procedure is done at an early age (younger than three months), about 80% of patients have some bile flow. In nearly 30% of those infants, enough bile is able to drain from the liver that bilirubin levels return to normal. In the smaller number of patients who don't benefit from the operation, some of the obstructed bile ducts are inside the liver as well as outside. When this happens, liver transplantation is needed sooner to correct the problem.
Source:
Children's Hospital of Pittsburgh www.chp.edu
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