Faye's journey through Biliary Atresia: Kasai surgery day

Saturday, August 18, 2012

Kasai surgery day

Surgery day was pretty rough on us because there was no set time for when they would perform on her. The nurses just told us, just to be safe, we would stop her feeds at 2:00 am. A rough night passed and 8:00 am in the morning had came, I was informed that we wouldn't be going for surgery that early and it could either be at 11:00 am or 2:00 pm. All we could that now was wait for when they would take us in. Anybody hospital parent would know that keeping your baby NPO is not a fun thing. We went the entire nigh and no the entire morning to afternoon still NPO. 11:00 am passed and at 12:16 pm the nurses let us know that we would be the 2:00 pm operation. Still though, we were still not able to give Faye anything. The entire day consisted of trying to keep her asleep so she wouldn't be awake and angry hungry. Finally 2:00 pm came along and all we heard was that surgery for the previous patient was going longed than expected. 4:41 pm came around, the surgeon walked in and said he'd have to delay Faye's surgery. Relieved that we had an answer but upset out baby went NPO all night and day for no reason, Dr. Anselmo let us know that he would be back and her surgery would be set for 9:30 pm.
We continued to wait the longest 3-4 hours ever, 8:45 pm they took us down to prep in the O.R. They explained everything to us, prepared Faye and by 10:00 pm we walked her to the doors where they took our baby girl.

Faye and Mommy

Faye's belly before surgery

Faye and Daddy

Faye with her Aunties and sister

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What is Biliary Atresia?

Biliary Atresia is a rare liver disease that only affects infants. Bile is a digestive liquid that is made in the liver. It travels through the bile ducts to the small intestine, where it helps digest fats.
In biliary atresia, the bile ducts become inflamed and blocked soon after birth. This causes bile to remain in the liver, where it starts to destroy liver cells rapidly and cause cirrhosis, or scarring of the liver.

What causes BA:
The cause of this disease is not known. In some infants, the condition is most likely congenital, meaning present from birth. About one in 10 babies with biliary atresia have other congenital defects. Some research indicates that an early viral infection may be linked to biliary atresia.
Scientists do know that biliary atresia is not hereditary; parents do not pass it on to their child. It is also not contagious, and it is not preventable. It is also not caused by anything an expectant mother did or did not do.

How is BA diagnosed:
Since other conditions lead to symptoms similar to those of biliary atresia, doctors must perform many tests before a conclusive diagnosis can be made. These tests may include blood and liver tests, an ultrasound examination, X-rays and a liver biopsy, in which a small amount of liver tissue is removed with a needle for examination in a laboratory.

How is BA treated:
Unfortunately, there is no cure for biliary atresia. The only treatment is a surgical procedure in which the blocked bile ducts outside the liver are replaced with a length of the baby’s own intestine, which acts as a new duct. This surgery is called the Kasai procedure after Dr. Morio Kasai, the Japanese surgeon who developed it.
The aim of the Kasai procedure is to allow drainage of bile from the liver into the intestine through the new duct. The operation is completely or partially successful about 80 percent of the time if performed early (before 3 months of age). In babies who respond well, jaundice and other symptoms usually disappear after several weeks.
In cases where the Kasai procedure does not work, the problem often lies in the fact that blocked bile ducts are “intrahepatic,” or inside the liver, as well as extrahepatic, or outside the liver. No procedure, except for liver transplant, has been developed to replace blocked intrahepatic ducts.
The Kasai procedure is most successful in babies younger than 3-months-old, so early diagnosis is important.
If the Kasai procedure is not successful, the only other option is a liver transplant. However, a suitable donor organ must be found quickly, before damage to the liver from the backed-up bile becomes deadly.

Babies with BA:
Without successful treatment, few children with biliary atresia live beyond age two. In some cases, where the Kasai procedure is completely successful, the child may recover and live a normal life. However, in most cases, even when surgery is successful, patients will suffer gradual damage to the liver. These children will need specialized medical care throughout their lives, and many will ultimately need a liver transplant.

Transplant:
In children with biliary atresia, a liver transplant is generally not attempted unless the Kasai procedure has been tried. In cases where that operation is unsuccessful, the child may become a candidate for a liver transplant. Success depends on the timely availability of a matching donor liver. Fortunately, survival rates for liver transplant recipients have increased dramatically with improved surgical techniques and the development of drugs that help overcome the problem of organ rejection.