Maharashtra: Infant undergoes Kasai surgery

A two-month-old baby underwent a successful Kasai surgery at the Wockhardt Group of Hospitals at Mira Road in Thane district in the far suburbs of Mumbai.

A team led by Dr Lalit Verma, a paediatric gastroenterologist and liver transplant specialist, performed a successful complicated Kasai procedure on a 2-month-old baby.

The baby was noticed to have increasing jaundice starting from 6 weeks of age.

A systematic assessment and diagnosis showed that the baby suffered from rare congenital liver disease called Biliary Atresia.

After a Kasai surgery, the baby presently now three months old and is accepting feeds, and passing regular stools.

The baby now weighs 4.3 kg.

The parents, residents of Mira Road, were elated on the birth of their first baby, a boy, Krisha.

He developed jaundice six weeks after of birth. His parents noticed symptoms such as jaundice, pale stools, bloated stomach, dark urine and excessive irritability.

They consulted Dr Samir Sheikh and Dr Lalit Verma about the baby's health. He was admitted to Wockhardt Hospital, Mira Road.
Dr Verma said: “At 6 weeks, the baby came presented with jaundice and symptoms such as the increased size of liver on sonography and liver biopsy was conducted that indicated the baby suffered from a rare congenital liver disease known as Biliary Atresia (BA).”

He said that it is a condition wherein the connecting duct between the liver and intestines is either absent or malformed since birth with an unknown cause.

The bile becomes stagnant in the liver and causes permanent liver damage. It is a fatal congenital liver disease found only 1 in 5,000 which goes undetected.

After counselling the family, the baby was scheduled for Kasai portoenterostomy procedure as it has to be performed within the 90 days of diagnosis.
During the surgery, the surgeon’s Dr Kant and Dr Pankaj recreated a duct using a small intestine and then attached it to the liver. This provides a path that can allow bile to drain from the liver. Surgery is not a cure for biliary atresia but it helps the liver work better for many years as it corrects many of the symptoms caused by the atresia. The surgery lasted for 4 hours.

The baby was in the ICU for 2 days and then shifted to the normal ward where he stayed for 5 days before getting discharged. The baby is tolerating feeds, passing stool and weighs 4.3 kgs on a Follow up after surgery.
“Our world came crashing down on knowing about Krisha’s condition. Fortunately, he received timely treatment at Wockhardt Hospital, Mira Road. We thank the doctors for saving his life. Krisha is back on track now,” the baby’s father said.

The Kasai procedure involves removing the blocked bile ducts and gallbladder and replacing them with a segment of your child's own small intestine. This segment of intestine is sewn to the liver and functions as a new extrahepatic bile duct system.