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Biliary Atresia – How to have a Happy, Healthy Liver!!
Overview
It is said that an average human heart beats more than three billion times in its lifespan. Human body, wondrous though it may be also houses some of the more delicate complications in existence. From the most important organs like the brain and the heart to the most rudimentary organs like the appendix, every part of the body has a purpose of its own no matter how menial it may be.
Bile, also known as gall, is a yellowish brown to greenish coloured fluid that is produced by the liver of almost all vertebrates. Its purpose is to aid in the digestion process of lipids in the small intestine. It is stored in the gall bladder (hence the name ‘gall’) despite being continuously produced by the human liver.
What is Biliary Atresia?
Biliary Atresia is a progressive disease of the liver and the bile ducts that affects only infants. Tubes in the liver called bile ducts allow bile juice to flow to intestines, kidney and stomach but in patients suffering from biliary atresia, the bile ducts are very narrow or blocked due to inflammation, or absent altogether. This disorder is also sometimes referred to as progressive obliterative cholangiopathy and extrahepatic ductopenia.
As the bile flow from the liver and the gall bladder is obstructed in biliary atresia, the bile won’t be able to leave the liver and the trapping of bile causes damage to the liver leading to liver cirrhosis or scarring of the liver (eventually leading to liver failure), which further causes the halting of various bodily functions like constriction of veins and difficulty in the supply of blood. This disorder can be congenital or acquired as well.
The particular cause for liver biliary atresia is unclear though some researchers suggest that the cause might be because of the malformation of bile ducts during pregnancy or may also be caused by exposure to infections or viruses or toxic substances in susceptible babies. It is often believed by some researches that biliary atresia may be distinguished in two kinds – Pre-natal (Embryonic) and perinatal.
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Symptoms
The biliary atresia symptoms may vary a little from child to child but the general symptoms that appear after the birth are
- Jaundice: Yellow pigmentation of the skin and the cornea of the eyes. The jaundice is developed between two or three weeks after birth
- Weight loss or poor weight gain: This develops when the severity of jaundice increases.
- Dark urine: As there is no proper distribution of bile and its components, bilirubin build up is caused as a result which is then filtered and then removed by the kidney as urine.
- Bloated abdomen and enlarged liver that feels harder than normal along with enlarged spleen.
- Clay-coloured stools (Acholic stools): As there is no bile or bilirubin reaching the stomach and the intestines, which usually gives stools their normal colour, the stools became pale coloured.
Treatment for Biliary Atresia
Preliminary Treatment
If the complications related to the liver and the bile are a little less, then they are mostly managed using medications and particular diets such as vitamin supplements (liquid) which can be given orally to reduce any deficiency that the baby may develop without. Though the medications cannot treat the disorder per se, it may only help in avoiding any further complications for the baby’s liver.
Kasai Procedure
The most recommended treatment for biliary atresia is hepatoportoenterostomy or commonly called as the ‘Kasai procedure’. It is a surgical procedure which helps in re-establishing the bile flow between the intestine and the liver by joining the two directly. This procedure does not completely cure biliary atresia; instead it just helps in slowing down the damage of the liver and hence delaying or preventing any further complications and the need for an immediate liver transplant.
What happens in the Kasai Procedure?
In the Kasai procedure, the surgeon will remove the deteriorated bile ducts (extrahepatic ducts) from inside the liver. A tiny section of the small intestine is then used to replace the damaged bile ducts and then connect the small intestine to the place where the bile is supposed to be housed or drained from in the liver. The bile juice will then flow directly from the liver to the small intestine. If this procedure is carried out in the first couple of weeks of birth, then the surgery is found out to be more effective producing better results.
Liver Transplant
If the Kasai procedure is unsuccessful or leads to complications, then the child will be required to undergo liver transplant. In a liver transplant, the damaged liver is surgically removed and is replaced by a new liver from a donor. The new liver can either be a part of a liver from a relative or other matching type person or from a dead person or it can be a whole liver from a dead person.
Success Rate and Risks Related to the Kasai Procedure (Biliary Atresia Surgery)
Gradual reduction of the jaundice is followed after the Kasai procedure is done on the infant. The infant will, in most cases, be made to stay in the hospital for 10 days following the surgery to recuperate and heal. A long-term prescription for antibiotics will be given to prevent the risk for infections like cholangitis, which is a type of an infection of the liver. If the infection still occurs, then the infant may be treated with antibiotics but this time its intravenous (IV).
If the surgery for biliary atresia is not successful, then the bile flow will remain blocked and the infant will develop complications overtime ending with the infant finally needing a liver transplant. Even when the Kasai procedure is successful, a lot of the treated infants will develop some complications with the passing time, usually over years or decades, eventually leading to liver transplant. Liver transplant is considered an absolute cure for biliary atresia but the infants will be required to undergo the surgery for liver transplant before the age of 2 or 3 years. In some rare cases, infants whom have undergone Kasai procedure may never need liver transplant; it is rare but an ever so present possibility.
If the Kasai procedure is carried out by an experienced surgeon, then the biliary atresia surgery success rate may vary from 80-85% depending upon the severity and the complications of the disease. 15-35% of Kasai procedures may end up not working forcing the child to undergo liver transplantation as a permanent solution.
Iranian Patients choosing India for their Liver Transplant solution
Sarina, Alinejad from Mashhad, Iran
"Hello, I am Ramtin Alinejad from Mashhad, Iran. I had come to India for my daughter’s liver treatment. My daughter Sarina was diagnosed with biliary atresia soon after her birth and the doctors had managed her illness with medications. But the treatment for biliary atresia was expensive and the doctor had said that she’d need to undergo surgery before her liver fails."
"The surgery cost for biliary atresia was very expensive in Iran and we could not afford it,but the surgery was necessary. A relative of ours suggested forerunners healthcare, a medical tourism company in India. After researching about the company we decided to go forward. We contacted them and they explained the whole process for the treatment."
"After our arrival, the doctors detailed everything that was going to happen in the surgery, that the surgery was a temporary solution and we’d have to wait for liver transplant. After understanding everything, we decided to go forward. The surgery called Kasai procedure was done. We waited a while for liver transplant after which the transplant surgery was done. Even after the procedure was completed, they took good care of us. I will recommend forerunnershealthcare to people in need."
Top 10 Hospitals for Biliary Atresia Surgery in India
- Rela Institute & Medical Centre
- Fortis Group of Hospital
- Global Group of Hospital
- BLK Super Specialty Hospital
- Yashoda Hospital
- Nanavati Super Specialty Hospital
- Artemis Specialty Hospital
- Apollo Spectra Hospital
- Jaslok Specialty Hospital
- Narayana Super Specialty Hospital
Best 10 Surgeons for Biliary Atresia Surgery in India
- Dr. Mohamed Rela
- Dr. A.S. Soin
- Dr. Avnish Seth
- Dr. Mettu Srinivas Reddy
- Dr. Vivek Vij
- Dr. Anupam Saha
- Dr. Murugan N
- Dr Rakesh Rai
- Dr. Sanjiv Saigal
- Dr. R.P.Singh Malhotra
Why Choose India for your Child’s Biliary Atresia Treatment?
India is becoming the leading choice for people wanting to undergo medical procedures but do not want to break the bank to acquire it. Medical procedures in India are one of the best and advanced in comparison to the developed nations. The surgeons that are in India are all highly trained professionals with years of experience under their belt having done some of the procedures in countries like Netherlands, Germany, USA, UK, Canada etc.
Biliary atresia treatment in India is performed with the most advanced medical and medicinal technologies yet the cost for the surgery is very low. Biliary atresia treatment cost in India is but a fraction of what people have to pay in western countries receiving the same high quality procedure.
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