Digestive and Gastrointestinal Conditions

Biliary Atresia Treatment

Biliary Atresia Treatment Options

Babies with biliary atresia need surgery to remove any blockage in the bile ducts outside the liver and create a way for bile to drain straight from their liver into their intestines. The surgery is called a Kasai procedure (portoenterostomy).

Kasai Procedure

During a Kasai procedure, the surgeon removes the scarred, abnormal bile ducts outside of the baby's liver. Then the surgeon creates an extension of the small intestine, called a roux-en-Y, that can reach up to the liver. The surgeon connects this extension to the liver at the place where the bile ducts come out of the liver.

The Kasai procedure tends to be more successful the earlier it's done. Usually the goal is to complete the surgery in the first two months after birth. The surgery may also be helpful for older babies, if they don't already have advanced liver disease.

Some children will recover with good liver function and bile flow after a Kasai procedure. Some will do well for a while, even a few years, and then their liver damage will get worse and their liver will fail. Then they will need a liver transplant.

For some children, a Kasai procedure will not help because their liver has too much damage. These children will need a liver transplant so they have a chance to survive.


Seattle Children's has the only pediatric liver transplant program in the Pacific Northwest. We have been performing liver transplant surgery since 1990.

More Details

You can read about what to expect when your child visits a clinic at Children's, has surgery here or needs to stay in the hospital. You can get practical details about topics like what to do and bring the day of surgery and who will be on your child's care team.