Hepatoportoenterostomy

The Kasai operation ( scientifically Hepatoporto - enterostomy ) is a late 1950s developed by the Japanese pediatric surgeons Morio Kasai method for the treatment of biliary atresia, a rare disease of the biliary tract, which occurs exclusively in the neonatal period.

Principle

After opening the abdomen, the diagnosis of Gallenwegatresie is first confirmed by looking at the liver and biliary tract. Subsequently, the liver by cutting through the straps to which it is suspended on the abdominal wall is folded out of the abdominal cavity. Now the proportion located outside the liver biliary tract is removed, including the connective tissue between the right and left portal vein. Finally, about 45 cm long intestinal loop Y -shape is from the rest of the small intestine off ( Y -Roux - loop ) and sewn onto the exposed hepatic portal, so that the bile can drip out of the running within the liver bile ducts directly into the intestine.

Complications

The direct connection of the intestine with the bile ducts can be favored by a slow flow of bile bacteria ascend into the bile ducts and lead to acute inflammation, cholangitis. This typically occurs in the first weeks to months after surgery for at least one to two -thirds of the operated children. Even after surgery, the bile flow starts up again, the blood pressure in the portal vein may increase later ( portal hypertension ). Thereby developing varicose veins of the esophagus ( esophageal varices ) can usually be obliterated during a gastroscopy and then require no further therapy more.

Source

• Therapeutic procedures in pediatric surgery
• Operative treatment procedures