NICH achieves milestone with first ever laparoscopic surgery of liver

An infant girl born with a damaged liver goes home on Tuesday after successful operation

KARACHI: In the first surgery of its kind in Pakistan, the National Institute for Child Health (NICH) managed to save the life of an infant girl born with a damaged liver.

Since birth, Areesha, who is now two-and-a-half years old, suffered incessant stomach aches and jaundice.

Her father, Umair Zaib, who works at a garment factory, told The Express Tribune that his daughter used to cry a lot after birth. He went to various doctors for treatment and momentarily the child would seem to be at ease. However, since last month Areesha was in extreme agony due to abdominal pain. Zaib said that he took her to Dr Ruth Pfau Civil Hospital and Abbasi Shaheed Hospital but to no avail. He said that people suggested he visit the NICH.

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Zaib took Areesha to the NICH on April 4. After various tests and ultrasound prescribed by Dr Muhammad Anwar, an associate professor and paediatric surgeon, the doctors at the hospital diagnosed that the child was born with a damaged liver or choledochal cyst, as it is known in the world of medicine.

The disease

Choledochal cyst involves cystic dilation of the bile ducts that are responsible for carrying bile from the liver and gallbladder to the small intestines. Bile is a dark-green or yellowish-brown fluid secreted by the liver to digest fats. Since the bile secretions could not be drained into the intestines, the cyst gradually led to infection and jaundice. In such a case, there is a possibility that liver may fail altogether.

To treat Areesha, the doctors recommended surgery using the laparoscopic technique. Such a surgery had never been performed in the country before and so, the hospital chief, Prof Jamal Raza, constituted a team of experts to perform this critical operation.

The team comprised Dr Sajid, Dr Basir, Dr Waliullah, Dr M Sajid and the paramedical staff.

The operation

The infant was administered anaesthesia and in an operation that lasted around six hours, the doctors dissected the infant's intestine and fashioned a tube out of it.

They then removed the damaged bile duct and transplanted the tube in its place.



Dr Anwar told The Express Tribune that it was the first operation of its kind to be performed in Pakistan. He said that they used the laparoscopic technique - a minimal invasive procedure - in which even the child's stomach was not opened. Instead, three ordinary holes were made in the infant's stomach and with the help of a camera, the damaged tube was successfully replaced with a new one. This procedure allowed the doctors to also save the infant's liver, said Dr Anwar.

The child has recovered and on Tuesday, she was discharged from the hospital.

Zaib said that his daughter was now healthy and had started eating and drinking as well. The family are residents of Kati Pahari.

Published in The Express Tribune, April 24^th, 2019.