Laparoscopic Kasai Portoenterostomy for Biliary Atresia

Abstract

The original hepatic portoenterostomy reported by Professor Morio Kasai was a revolutionary procedure that greatly improved the clinical status of biliary atresia patients and actually gave them a viable prognosis for the first time. A video of Kasai performing a portoenterostomy was scrutinized to recreate his original technique because the current open portoenterostomy has been modified extensively. Laparoscopic Kasai, a portoenterostomy according to Kasai’s original technique, was performed for the first time in 2009, with special attention paid to the level of transection of the biliary remnant and the depth of suturing to prevent injury to remnant ductules that may be present. The overall outcome of laparoscopic Kasai can only be determined after extended follow-up and comparison with postoperative open portoenterostomy.