University of California San Francisco

Kasai Procedure

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.

The operation will be performed by a Pediatric Surgeon who has had special training in the management of surgically correctable problems in children. The surgeon may be able to operate through many small incisions (laparoscopic surgery) instead of one large (open surgery) incision. The surgeon will determine the safest method of operating and will discuss this with you before the procedure takes place. The operation will take approximately 4 hours to complete.

What are the possible outcomes for patients after a Kasai procedure?

Normal restoration of bile flow and recovery of liver function occurs in approximately one third of children who undergo the Kasai procedure. These children may not require liver transplantation. The remaining two thirds of children who undergo the Kasai procedure will not have adequate bile flow and liver function, and will eventually require liver transplantation. Of this group, half will need transplantation soon after the Kasai procedure and half will need transplantation at a later time.

Post-operative recovery

After the operation, your child will be cared for in the recovery area, and you can be with him or her while he or she is waking up. From the recovery room your child will be transferred to the pediatric floor and will stay in the hospital for several days. Once your child is able to eat well, has no fever, and is comfortable on pain medication by mouth, he or she will be discharged home.

Do I need to see the surgeon again after the operation?

One or two weeks after you arrive home from the operation a nurse from our office will call you to see how your child is doing. Please call our office if you have any questions or concerns after the surgery. Your child will need an appointment with the Gastroenterologist and our surgeon two or three weeks after discharge from the hospital.