Kasai portoenterostomy

Last revised by Subhan Iqbal on 27 Feb 2021

Kasai portoenterostomy is the surgery that comprises exposing the porta hepatis by radical excision of all bile duct tissue up to the liver capsule and attaching a Roux-en-Y loop of jejunum to the uncovered liver capsule above the bifurcation of the portal vein creating a portoenterostomy 1.

  • extra and intrahepatic biliary atresia 2,3,5
  • the accomplishment of the successful Kasai portoenterostomy in patients with biliary atresia is free radiotracer spillage into small bowel loops
  • other criteria are serum bilirubin levels < 57 micromol/l, 42 days after the Kasai procedure
  • patients with serum bilirubin higher than this threshold frequently scanned for liver transplantation 4

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