Paediatric HPB Diseases & Surgeries

Children with liver, biliary, and pancreatic diseases present unique diagnostic and surgical challenges that differ significantly from adult HPB conditions — both in disease spectrum and in the physiological, anatomical, and emotional considerations involved in their care. At Ahmedabad Liver Surgeons, we offer specialised paediatric HPB surgery in close collaboration with paediatric hepatologists, paediatric intensivists, and dedicated paediatric nursing teams to provide seamless, family-centred care for children from newborns to adolescents.

The most common and critical paediatric biliary condition is biliary atresia — a progressive obliterative cholangiopathy affecting the extrahepatic bile ducts presenting in the first weeks of life with prolonged neonatal jaundice, pale stools, and dark urine. It is the leading indication for paediatric liver transplantation worldwide. The Kasai portoenterostomy is the initial surgical treatment, establishing bile drainage before cirrhosis sets in; it is most effective when performed before 60 days of life. Choledochal cysts (bile duct cysts, Todani classification Type I–V) are congenital dilations of the biliary tree managed with complete cyst excision and Roux-en-Y hepaticojejunostomy to prevent complications of cholangitis and malignant transformation. Other conditions include neonatal hepatitis, Alagille syndrome, Wilson's disease, autoimmune hepatitis, and metabolic liver diseases.

Paediatric liver transplantation is a life-saving operation for children with end-stage liver disease from biliary atresia, metabolic disorders (PFIC, MSUD, OTC deficiency, Crigler-Najjar syndrome), acute liver failure, and hepatoblastoma. Living-donor transplantation — utilising the left lateral segment (segments 2 and 3) from a parent or close relative — is the predominant modality in India, offering excellent graft-recipient size matching and shorter waiting times. Our surgeons are proficient in reduced, split, and left lateral segment living-donor liver transplantation for children, with a dedicated team ensuring the highest standards of donor safety and recipient outcomes.

Paediatric HPB Conditions We Treat

• Biliary atresia — Kasai portoenterostomy and liver transplantation
• Choledochal cysts (Types I–V) — excision and biliary reconstruction
• Paediatric liver transplantation (living donor — left lateral segment)
• Hepatoblastoma and liver tumours — resection and transplant
• Wilson's disease and other metabolic liver diseases
• Progressive familial intrahepatic cholestasis (PFIC)
• Autoimmune hepatitis in children
• Paediatric acute pancreatitis and pancreatic pseudocysts
• Congenital hepatic fibrosis and Caroli disease