Patient records:
Name: Budi
Age: 45 days
Nationality: Indonesia
Diagnosis: Biliary atresia
Treatment Hospital: Children's Hospital Affiliated to Fudan University (National Children's Medical Center)
During the 60-day golden window, we rebuild the river of life for children with gallbladder deficiency.
Budi was born in Surabaya, Indonesia. Like all newborns, he developed neonatal jaundice. However, unlike others, his jaundice persisted, and his stools became increasingly pale, eventually turning a horribly dark "clay color." His abdomen also became increasingly distended due to liver cirrhosis. Local doctors suspected biliary atresia—a progressive inflammation and fibrosis of the intrahepatic and extrahepatic bile ducts that prevents bile from draining completely. Without timely surgery, the child would die of liver failure within 1-2 years of age. The Kasai Procedure, used to treat this condition, must be performed within the golden window of 60-90 days after birth; otherwise, the success rate is extremely low.
When Buddy's parents contacted us through an online consultation, Buddy was already 45 days old, and the window of opportunity was closing rapidly. Our case manager immediately recognized this as a top priority case. Without wasting a minute, we focused directly on the Department of Surgery at the Children's Hospital of Fudan University. Professor Zheng Shan's team at that hospital is a leading authority in the diagnosis and treatment of biliary atresia in China. Their "laparoscopic-assisted Kasai procedure" is renowned for its minimally invasive nature and high precision, maximizing the time available for children to use their own liver.
Our service is a race against time. We completed the translation and summarization of all of Buddy's medical records within 24 hours and urgently arranged a remote video consultation with a pediatric surgery expert from Fudan University. Based on the uploaded liver function indicators and ultrasound images, the expert highly suspected biliary atresia and recommended immediate surgery in China. We simultaneously initiated expedited medical visa processing and booked the apartment closest to the hospital.
Buddy arrived in Shanghai on his 52nd day after birth, by which time his direct bilirubin levels had risen sharply. Our coordinator was already waiting at the hospital, and he was admitted quickly through the green channel. During the surgery, the doctors removed the obstructed extrahepatic bile duct laparoscopically and anastomosed a section of small intestine to the porta hepatis, creating a completely new "artificial channel" for bile. Our translator accompanied the family throughout the entire procedure, explaining every step of the surgery.
The success of the Kasai procedure was 30% due to the surgery itself and 70% due to management. Post-surgery, our nutritionist assisted in customizing a special formula feeding plan for Buddy, rich in medium-chain triglycerides (MCTs), to promote bile excretion and nutrient absorption. We taught Buddy's mother how to observe stool color, a "barometer" of bile drainage patency. After returning to China, we established a rigorous "cholangitis early warning and follow-up system," tracking liver function indicators monthly. If any abnormalities were detected, we immediately coordinated remote intervention with experts from Fudan University's pediatric department. We seized the fleeting golden window, using professionalism and speed to illuminate Buddy's childhood, free from the shadow of jaundice.