Operative Procedures: Open Kasai Procedure

In biliary atresia, the extrahepatic biliary tract is completely obstructed, showing various morphologic patterns of obstruction on a case-by-case basis. Hepaticoenterostomy is performed when the hepatic duct is sufficiently open for anastomosis with the intestinal tract (correctable type) in types I and II. However, such a disease type is rare, and Kasai portoenterostomy is performed in most cases. In this procedure, the extrahepatic biliary remnant containing obstructed bile ducts is transected at the appropriate level and removed. Then, the intestine is anastomosed to the liver tissue at the hepatic hilum covering the resected area of the removed remnant. We present our current techniques for open Kasai portoenterostomy.