Kasai procedure - case study

Nursing

The Kasai procedure involves removing the blocked bile ducts and gallbladder and replacing them with a segment of the child's own small intestine. This segment of intestine is sewn to the liver and functions as a new extrahepatic bile duct system. Either using an incision made below the ribs on the right of the abdomen or a laparoscopic technique, the bile ducts are first inspected. A study called a cholangiogram is performed to confirm the diagnosis of biliary atresia. To perform a cholangiogram, the surgeon places a small tube into the gallbladder, if present. Then they inject a medication that can help find the bile ducts using an X-ray machine. If the gallbladder and bile ducts are not open and bile cannot drain, the child has biliary atresia. The surgeon will proceed to remove the very small or abnormal gallbladder and abnormal bile ducts where they connect with the liver. A piece of small intestine called the jejunum is then used to replace the bile ducts, making a connection between the liver and the intestine. This connection will hopefully re-establish bile drainage into the intestine, reversing the effects of the disease.

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