<s>[INST] my son was diagnosed with biliary atresia . when he was 2 weeks old, his bilirubin was high, cholic stools. doctors ordered intraoperative cholangiogram and they later found out his duct is fibrotic, so they took away his gallbladder and did another procedure, the Kasai procedure. Now, 2 weeks after operation his total bilirubin went down to 23 but his sgpt is still going up, 5 times the normal value. another 2 weeks passed, his total bilirubin is 12 but his sgpt is 241. what does this indicate?his sgpt keeps going up? his liver biopsy result when he had the operation is good. im concerned about the sgpt. if sgpt keeps going up, that means his liver is in the process of scarring? [/INST] Hi and welcome to Chat Doctor thanks for the query. Biliary amnesia is serious congenital anomaly and Kasai procedure is the only chance for them despite transplantation. Kasais procedure has high rate of complication, and it is not always successful. However these findings are still not alarming as this is expected after such surgeries and of course his liver won't function as it was healthy. Some elevation of LFT is expected, and he needs only frequent check up. Wish you good health. Regards </s>