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Written & reviewed by Vikram Kashyap, Medical Consultant, Satyug Healthcare
·Last updated: ·Editorial policy
See the cost breakdown by option, hospital and city →
| Surgery Name | Cost | Room | Hospitalization |
|---|---|---|---|
| Kasai Procedure Package | 7000 USD | Private / Twin Sharing Room | 10-14 days in hospital; total stay in India 3-4 weeks |
| Kasai Portoenterostomy (standard) | 7000 USD | Twin Sharing | 10-14 days hospital |
| Kasai Portoenterostomy with Extended Intensive Care | 9000 USD | Private Room | 14-21 days hospital |
✓ Inclusion
- ✔Consultation with paediatric surgeon and paediatric hepatologist
- ✔Pre-anaesthesia assessment by paediatric anaesthetist
- ✔Intra-operative cholangiogram to confirm diagnosis
- ✔Kasai portoenterostomy (hepatoportoenterostomy) with Roux-en-Y loop
- ✔Surgeon, assistant and anaesthetist fees
- ✔Operation theatre charges and standard consumables
- ✔Paediatric / neonatal ICU care as per package
- ✔10–14 days hospital stay in a twin-sharing room with mother
- ✔Standard medicines, IV fluids, antibiotics and feeds during stay
- ✔Routine blood tests and liver function monitoring during admission
- ✔Discharge summary with medicine, nutrition and follow-up plan
- ✔Free: airport pick-up & drop, visa invitation letter, interpreter & coordinator (Satyug Healthcare)
✗ Exclusion
- ✖HIDA scan, liver biopsy and other diagnostic tests before surgery (if needed)
- ✖Extended ICU stay or extra hospital days beyond the package
- ✖Blood and blood products
- ✖Special formula, MCT oil and vitamins after discharge
- ✖Liver transplant evaluation and surgery
- ✖Treatment of cholangitis or other complications after discharge
- ✖Hotel accommodation for parents before or after admission
- ✖Flights, visa fees and travel insurance
- ✖Private room upgrade (available in extended care package)
Know More About Procedure & Surgery
🇮🇳 PAEDIATRIC SURGERY PACKAGE — INDIA
Kasai Procedure (Biliary Atresia Surgery) in India
Kasai portoenterostomy for babies with biliary atresia, done urgently by experienced paediatric surgeons and paediatric hepatologists at Indian centres that also offer paediatric liver transplant – at a fraction of the cost in the West.
✅ Free Medical Opinion in 24–48 h (urgent)👶 Paediatric Liver Specialists💰 Starting USD 7,000✈️ Visa & Airport Support🗣️ Interpreter Available
⏱️
3–5 hrs
Surgery time
🏥
10–14 days
Hospital stay
📈
50–60%
Clear jaundice after surgery
📅
3–4 weeks
Total stay in India
📖 What is Biliary Atresia and the Kasai Procedure?
Bile is a yellow-green fluid made by the liver that helps digest fat. It flows through tubes called bile ducts into the intestine. In biliary atresia, a rare disease of newborn babies (about 1 in 5,000–19,000 births), the bile ducts outside the liver become inflamed, scarred and blocked in the first weeks of life. Bile stays in the liver, causing yellow skin and eyes (jaundice) beyond 2 weeks of age, pale or white stools and dark urine. Without treatment, the liver becomes scarred (cirrhosis) and most babies die before age 2.
The Kasai procedure (also called hepatoportoenterostomy or Kasai portoenterostomy) is an operation that removes the blocked ducts and joins a loop of the baby's small intestine directly to the surface of the liver (at the porta hepatis), where tiny bile channels remain. This lets bile drain into the intestine. It works best when done early – ideally before 60 days of age. If jaundice clears, many children keep their own liver for years; if it does not, or the liver fails later, a liver transplant is needed. Kasai surgery is the first treatment for almost all babies with biliary atresia.
🖼️ Understand It in Pictures
💡 In simple words
In biliary atresia, a baby’s bile tubes are blocked or missing, so bile is trapped and damages the liver. In the Kasai procedure, the blocked tubes are removed and a loop of intestine is joined to the liver so bile can drain. It works best when done early.
Normal liver vs biliary atresia vs after Kasai
👀 Symptoms in Pictures
🩻 Scans & Tests — What Doctors See
🎬 The Treatment Journey in Pictures
📅 Recovery at a Glance
Drawings: Satyug Healthcare (simplified, not to scale). Photos: Wikimedia Commons; author and licence under each photo.
🩺 Conditions Treated
👶
Type III biliary atresia
The most common type (about 90%), where the ducts are blocked up to the liver – the main reason for Kasai surgery.
🟡
Type I & II biliary atresia
Blockage lower down the duct system; also treated with Kasai or similar drainage operations.
🔗
Biliary atresia splenic malformation (BASM)
Biliary atresia with other birth differences such as many small spleens or heart defects.
🫧
Cystic biliary atresia
A form with a cyst in the duct, often seen on scans before birth – best results with early surgery.
⏳
Late-diagnosed babies
Babies older than 90 days may still benefit in selected cases; others are referred for liver transplant.
🩺
Prolonged newborn jaundice workup
Babies with unexplained jaundice and pale stools needing urgent diagnosis and surgery.
⚠️ Warning Signs in a Baby
- ➤Jaundice (yellow skin or eyes) after 2 weeks of age
- ➤Pale, clay-coloured or white stools
- ➤Dark yellow urine that stains the nappy
- ➤Enlarged, firm liver
- ➤Poor weight gain
- ➤Swollen tummy
- ➤Easy bruising or bleeding (vitamin K deficiency)
- ➤Itching and irritability in older babies
💡 Not every jaundiced baby has biliary atresia. Most newborn jaundice is harmless and clears by 2 weeks. Other causes such as neonatal hepatitis, Alagille syndrome, choledochal cyst or metabolic diseases need different treatment. Babies diagnosed very late with advanced cirrhosis may go directly to liver transplant instead of Kasai.
🔬 Tests Before Treatment
| Test | Why it is done |
|---|---|
| Liver function tests (direct bilirubin, GGT) | Raised conjugated (direct) bilirubin points to bile blockage. |
| Ultrasound abdomen (fasting) | Looks for a small or absent gallbladder and the 'triangular cord' sign. |
| Stool colour card check | Pale stools are a strong warning sign. |
| HIDA scan (hepatobiliary scan) | Checks if bile reaches the intestine; no flow suggests atresia. |
| Liver biopsy | Shows the typical changes of bile duct blockage and rules out other diseases. |
| Intra-operative cholangiogram | Dye X-ray during surgery confirms the diagnosis before Kasai is done. |
| Blood clotting tests (INR), CBC, metabolic screen | Check bleeding risk and rule out other causes. |
🏥 The Procedure — Step by Step
1
Urgent arrival
The baby is admitted under paediatric hepatology and paediatric surgery soon after arrival.
2
Confirming diagnosis
Blood tests, ultrasound, HIDA scan and biopsy are done quickly, usually within a few days.
3
Preparation
Vitamin K, nutrition support and antibiotics are given; blood is kept ready.
4
Anaesthesia
General anaesthesia is given by a paediatric anaesthetist.
5
Cholangiogram
The surgeon injects dye into the gallbladder to confirm the ducts are blocked.
6
Removing scarred ducts
The scarred bile duct remnant is removed up to the liver surface (porta hepatis).
7
Roux-en-Y loop
A 40–50 cm loop of small intestine is joined to the liver surface to drain bile.
8
Paediatric ICU
The baby is monitored in the PICU/NICU for 1–3 days with pain relief and fluids.
9
Ward recovery
Feeding restarts; steroids (in some centres), antibiotics, ursodeoxycholic acid and vitamins begin; stool colour is watched.
10
Discharge
The baby goes home after about 10–14 days with medicines, vitamins and a follow-up plan.
⚖️ Types & Techniques
| Option | What is done | Best for |
|---|---|---|
| Open Kasai portoenterostomy (this package) | Bowel loop joined to liver through an upper tummy cut | Standard treatment for most babies |
| Kasai with extended intensive care | Same surgery with longer PICU care and private room | Low weight, sick or late babies, BASM |
| Laparoscopic Kasai | Keyhole approach | Selected centres; open surgery remains the standard |
| Paediatric liver transplant | Liver from a parent (living donor) replaces the diseased liver | Failed Kasai, very late diagnosis, liver failure |
📊 International series report clearance of jaundice in about 50–60% of babies after Kasai, with native-liver survival of about 40–50% at 5 years; outcomes are clearly better when surgery is done before 60 days of age, and overall survival with liver transplant backup exceeds 85–90%.
📅 Your Day-by-Day Plan in India
| Day | What happens |
|---|---|
| Day 1 | Arrival in India, airport pick-up and urgent admission |
| Day 2–4 | Confirmatory tests: blood tests, ultrasound, HIDA scan, liver biopsy |
| Day 4–5 | Kasai surgery under general anaesthesia |
| Day 5–7 | Paediatric ICU care |
| Day 8–16 | Ward recovery, feeding and medicines; discharge after 10–14 days in hospital |
| Day 17–24 | Stay near hospital; weekly bilirubin, stool colour and nutrition review |
| Day 25–28 | Final review with paediatric hepatologist; fly home ✈️ |
🌱 Recovery After Treatment
🏥
Week 1–2
PICU then ward care; feeds restart; antibiotics and medicines started.
🟢
Week 2–6
Stools should turn yellow or green if bile is flowing; bilirubin checked weekly.
🍼
Month 1–3
Special formula with MCT oil and fat-soluble vitamins (A, D, E, K) for growth.
📉
Month 3
Bilirubin below about 2 mg/dL (34 µmol/L) is a good sign of success.
🌡️
Months 1–24
Watch for fever (cholangitis) – needs urgent hospital antibiotics.
📅
Lifelong
Regular liver checks; some children need a liver transplant later in life.
🏆 Success Rate
| Outcome | Result |
|---|---|
| Clearance of jaundice after Kasai | About 50–60% |
| Native liver survival at 5 years | About 40–50% |
| Native liver survival at 20 years | About 25–35% |
| Best results | Surgery before 60 days of age |
| Overall survival with transplant backup | Over 85–90% |
The most important factors are the baby's age at surgery (earlier is better), how much liver scarring is already present, the experience of the surgical centre, and preventing cholangitis after surgery.
🩹 Risks & Possible Complications
The Kasai procedure is major surgery in a small baby; the team watches closely for these problems.
- •Cholangitis (infection of the bile channels) – about 40–60% in the first 2 years
- •Failure of bile drainage, needing liver transplant
- •Portal hypertension and bleeding from enlarged veins in later years
- •Poor growth and vitamin deficiencies
- •Wound infection or leak from the bowel join (uncommon)
- •Bowel blockage from adhesions (uncommon)
- •Anaesthesia and bleeding risks in a small baby
💰 Cost of Kasai Procedure in India
The cost of the Kasai procedure for biliary atresia in India starts from about USD 7,000 for the standard package with 10–14 days in hospital (twin-sharing room). The package with extended intensive care and a private room for 14–21 days costs about USD 9,000.
| Option / Hospital tier | Approx. cost (USD) | Hospital stay | Notes |
|---|---|---|---|
| Kasai Portoenterostomy – standard (this package) | 7,000 | 10–14 days – twin sharing | Includes PICU and surgery |
| Kasai with extended intensive care | 9,000 | 14–21 days – private room | Low weight, sick or late babies |
| Diagnostic workup only (HIDA, biopsy) | 800 – 1,500 | 2–4 days | If diagnosis is not yet confirmed |
| Paediatric living-donor liver transplant | 25,000 – 35,000 | 4–6 weeks | For failed Kasai or late cases |
⚠️ Final cost depends on the baby's age, weight and general condition, the length of PICU stay, extra tests or blood products, and the hospital chosen. Quotes are confirmed after the specialist examines the baby in India.
📋 What the Package Includes
✅ Included
- ✔Paediatric surgeon & anaesthetist fees
- ✔Intra-operative cholangiogram
- ✔Kasai portoenterostomy surgery
- ✔PICU/NICU care (standard)
- ✔10–14 days hospital stay
- ✔Standard medicines & feeds
- ✔Free airport pick-up & coordinator
❌ Not Included
- ✖Pre-op HIDA scan & liver biopsy (if not done)
- ✖Extended PICU stay beyond package
- ✖Blood & blood products
- ✖Special formula & vitamins after discharge
- ✖Liver transplant evaluation
- ✖Hotel stay for parents
- ✖Flights & visa fees
✈️ Your Medical Travel Process with Satyug Healthcare
| Step | Details |
|---|---|
| 1. Send reports | Baby's date of birth and birth weight, liver function tests (total and direct bilirubin, GGT), ultrasound abdomen report, HIDA scan and liver biopsy (if done), photos of the baby's stool and urine colour, and any discharge summaries. |
| 2. Free opinion & quotes | Within 48-72 hours you receive opinions and cost estimates from 3-5 leading hospitals to compare. |
| 3. Choose hospital & doctor | We help you compare doctors, success rates, room options and total budget. |
| 4. Medical visa | The hospital issues a Visa Invitation Letter (VIL) to the Indian Embassy. The patient and up to 2 attendants apply for an e-Medical / Medical Attendant visa. |
| 5. Travel planning | Flight guidance, wheelchair assistance, airport pick-up, hotel or guest house near the hospital. |
| 6. Treatment in India | Your coordinator and interpreter stay with you for admission, treatment, discharge and billing. |
| 7. Return & follow-up | Fit-to-fly letter, medicines, and online follow-up with your doctor after you return home. |
🎒 Travel Checklist
- 📌Valid passport (6+ months) for the patient and attendants, plus 10 passport-size photos each
- 📌Medical visa / e-visa and the hospital’s Visa Invitation Letter
- 📌All liver tests, ultrasound / HIDA / biopsy reports, stool colour photos and prescriptions
- 📌Yellow fever vaccination certificate (mandatory for travellers from African countries)
- 📌Polio vaccination certificate where applicable
- 📌Declare cash above USD 5,000 at the airport; hospitals accept wire transfer and cards
- 📌Foreigners staying longer than permitted must register with the FRRO — our team assists
⭐ Why Choose Satyug Healthcare?
🏥
Top Accredited Hospitals
Kasai surgery is done at centres with paediatric surgery, paediatric hepatology and paediatric liver transplant programmes, such as Medanta – The Medicity, Institute of Liver and Biliary Sciences (ILBS) New Delhi, Sir Ganga Ram Hospital, Indraprastha Apollo, Max Saket, Narayana Health Bengaluru and Rainbow Children's Hospital.
👨⚕️
Senior Specialists
Your baby is treated by a joint team of paediatric surgeons, paediatric hepatologists, paediatric anaesthetists and neonatal intensive care specialists.
💵
Transparent Pricing
Multiple written quotes to compare — no hidden charges, no extra fee for our service.
🤝
End-to-End Support
Visa, airport pick-up, accommodation, interpreter and 24/7 coordinator.
❓ Frequently Asked Questions
➤ How much does the Kasai procedure cost in India?
The standard package starts from about USD 7,000 with 10–14 days in hospital. Babies who need longer intensive care cost about USD 9,000. You receive a written quote after the doctors review the reports.
➤ How urgent is the surgery?
Very urgent. Results are best when Kasai is done before 60 days of age, and every week of delay lowers the chance of success. Please send reports immediately if your baby has jaundice and pale stools.
➤ Can Kasai still be done after 90 days?
Sometimes. The surgeon checks liver scarring. If the liver is badly scarred, a liver transplant may be a better option.
➤ How long will the baby stay in hospital?
About 10–14 days, including 1–3 days in paediatric ICU. Babies who need extended care may stay 14–21 days.
➤ How long should we stay in India?
About 3–4 weeks in total, so the team can check bilirubin, stool colour and nutrition before you fly home.
➤ What is the success rate?
About 50–60% of babies clear their jaundice after Kasai. About 40–50% still have their own liver at 5 years. With liver transplant as backup, more than 85–90% of children survive long-term.
➤ How do we know if the surgery worked?
The stool turning yellow or green and bilirubin falling to normal by about 3 months are good signs.
➤ Will my baby need a liver transplant later?
Many children do at some point – about half by school age. Some keep their own liver into adult life. Regular check-ups help plan this early.
➤ What is cholangitis?
It is an infection of the bile channels causing fever, more jaundice and pale stools. It is common in the first 2 years and needs urgent hospital antibiotics.
➤ What will my baby eat after surgery?
Breast milk can continue, often with a special formula containing MCT oil. Extra vitamins A, D, E and K are given.
➤ Is the surgery painful for the baby?
The baby is fully asleep during surgery and receives strong pain relief afterwards. Paediatric nurses watch comfort closely.
💬 Get a Free Opinion & Cost Estimate
Send your medical reports today and receive opinions from India’s top specialists within 48-72 hours.
📞 +91-8860606766 | +91-9910655125 | ✉️ query@satyughealthcare.com
Medical disclaimer: This page is for general information and does not replace a consultation with a qualified specialist. Treatment plans and costs are confirmed only after the patient is examined. Sources: NCBI StatPearls: Biliary Atresia; NCBI StatPearls: Kasai Procedure; Cleveland Clinic: Biliary atresia; NHS: Biliary atresia; NIDDK: Biliary Atresia; Davenport M et al., biliary atresia outcome studies (King's College Hospital); Japanese Biliary Atresia Registry; North American Society for Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN) guidance. Infographics: Satyug Healthcare.
Frequently Asked Questions
The cost of Kasai procedure in India starts from USD 7000. Kasai Portoenterostomy (standard): USD 7000; Kasai Portoenterostomy with Extended Intensive Care: USD 9000. The final cost depends on the hospital, room category and medical condition.
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Kasai procedure for biliary atresia in India from USD 7,000 with 10–14 days in hospital. Paediatric liver surgeons, PICU & transplant backup. Free opinion.
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