How is it possible to tell if the operation has been successful?
At the time of operation the surgeon will not to be able to tell if bile drainage will occur satisfactorily. The first stools after the operation are usually very dark, they then will become paler. If bile drainage does occur the stools gradually change to a yellow / green / brown colour and later the urine becomes paler.

The colour of the stools will be monitored whilst your baby in is hospital. It is not unusual for there to be some variation in the colour of the stools. It is impossible to say how long it may take to observe these change as every baby is different.

If bile drainage is established the jaundice gradually fades and blood tests show that the chemical, bilirubin that causes jaundice, drops towards a normal level. Since the operation may not drain bile from all section of the liver it is not unusual for liver function tests to remain abnormal even if the jaundice completely clears.

Satisfactory bile drainage occur in approximately 80% of children who undergo the Kasai operation before the age of eight weeks. The incidence of successful bile drainage is lower if the baby is over 8 weeks old. However, even some of the children who lose their jaundice may develop some of the complications due to liver damage. So all children continue to seen for regular checkups.

Professor Kasai who first performed this operation in Japan in the 1950’s has found that 90% of patients who lose their jaundice are alive and well at almost 15 years of age. Since the operation is a relatively new one, the longer-term prognosis is, as yet, less certain.

What happens if the biliary atresia is not treated or treatment is unsuccessful?
In these cases bile produced in the liver builds up causing damage to the cells of the liver eventually resulting in severe scarring (cirrhosis). If this continuous liver function deteriorates, complications occur and general health suffers. In the past sadly these children often died in infancy, but liver transplantation has altered this outlook and is now an accepted form of treatment. It is only considered when other treatments are ineffective.

Liver transplantation became available for children in the 1980’s, the results are now encouraging and are steadily improving. There is an overall 80% one-year survival rate for liver transplantation. Liver transplantation is now possible in children of any age.

If liver transplantation is indicated for your child this will be discussed with you by the team caring for you and your child. Diet and medication will be intensified in order to ensure that your baby or child is as well as possible leading up to transplant, and progress will be monitored. The aim of liver transplantation is to restore your child to good health.

Last created on 21-02-2001
Last updated on 18-11-2006