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Biliary Atresia

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After Surgery

Both before and after the Kasai procedure, infants will receive a specific diet with the right mix of nutrients and vitamins in a form that does not require * bile to be absorbed. Poor nutrition can lead to problems with development, so doctors will monitor an infant's nutritional intake closely.

Some infants develop fluid in the abdomen after the Kasai procedure, which makes the baby's belly swell. This condition is called ascites and usually only lasts for a few weeks. If ascites lasts for more than 6 weeks, * cirrhosis is likely present and the infant will probably require a liver transplant.

Also common after the Kasai procedure is infection in the remaining bile ducts inside the liver, called cholangitis. Doctors may prescribe antibiotics to prevent cholangitis or prescribe them once the infection occurs.

Children with biliary atresia may continue to have liver problems after the Kasai procedure. Even with success of the operation and return of bile flow, some children will develop injury and loss of the small bile ducts inside the liver, which can cause scarring and cirrhosis.

The liver affected by cirrhosis does not work well and is more rigid and stiff than a normal liver. As a result, the blood flow through the liver is slowed and under higher pressure. This condition is called portal hypertension. Portal hypertension can also cause flow of blood around, rather than through, the liver. This complication can cause intestinal bleeding that may require surgery and may eventually lead to a recommendation for liver transplantation.

Cirrhosis of the liver can also lead to problems with nutrition, bruising and bleeding, and itching skin. Itching, called pruritus, is caused by the build up of bile in the blood and irritation of nerve endings in the skin. Doctors may prescribe medications for itching including resins that bind bile in the intestines or antihistamines that decrease the skin's sensation of itching.

After liver transplantation, an important regimen of medicines is used to prevent the immune system from rejecting the new liver. Doctors may also continue to prescribe special diets, vitamins, blood pressure medications, and antibiotics.

Definitions For This Page - In Alphabetical Order

* Cirrhosis
Pronounced - suh-ROH-sis
Cirrhosis is scarring of the liver. Scar tissue forms because of injury or long term disease. More about Cirrhosis

* Bile
Pronounced - BY-ul
Bile is the fluid made by the liver and stored in the gallbladder. Bile helps break down fats and gets rid of wastes in the body.

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References:
National Digestive Diseases Information Clearinghouse (NDDIC)
July 2006
digestive.niddk.nih.gov

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