Hepatoportoenterostomy
| Hepatoportoenterostomy | |
|---|---|
 Intraoperative view of complete biliary atresia. | |
| Other names | Kasai portoenterostomy |
| ICD-10-PCS | 0F194ZB |
| ICD-9-CM | 51.37 |
AhepatoportoenterostomyorKasai portoenterostomyis asurgicaltreatment performed on infants with Type IVbcholedochal cystandbiliary atresiato allow forbile drainage.In these infants, thebileis not able to drain normally from the smallbile ductswithin theliverinto the larger bile ducts that connect to thegall bladderandsmall intestine.[citation needed]
Procedure
[edit]The surgery involves exposing theporta hepatis(the area of the liver from which bile should drain) by radical excision of all bile duct tissue up to the liver capsule andattachingaRoux-en-Yloop of jejunum to the exposed liver capsule above the bifurcation of the portal vein creating a portoenterostomy.[1]The rationale for this approach is that minute residual bile duct remnants may be present in the fibrous tissue of the porta hepatis and thus provide direct connection with the intrahepatic ductule system to allow bile drainage.[2]
This procedure was developed in 1951 by Japanese biliary and hepatic pediatric surgeonMorio Kasai(1922–2008).[3][4][5]
Prognosis
[edit]Prognosis of this condition/procedure comprises the following:[citation needed]
- If performed before 60 days of age, 80% of children achieve somebiledrainage
- Prognosis is progressively worse the later surgery is done
- Post-operatively,cholangitisandmalabsorptionare common
- Many children with biliary atresia will requireliver transplantationdespite the attempted surgical repair, although on occasion, it can be delayed until adulthood.[6]
See also
[edit]References
[edit]- ^Bailey & Love's Short Practice of Surgery.Boca Raton, Florida: CRC Press. 2013. p. 1105.ISBN9781444121278.
- ^Behrman et al. Nelson Textbook of Pediatrics. Philadelphia: W.B. Saunders Company, 2000.
- ^Ryoji Ohi (2009)."Morio Kasai, MD 1922-2008".Journal of Pediatric Surgery.44(3). Elsevier Inc.: 481–482.doi:10.1016/j.jpedsurg.2009.01.001.
- ^http://www.chp.edu›... › Educational Resources › Liver Transplant Patient Procedures
- ^de:Kasai Morio
- ^Segura-Sampedro J.J.; C. Bernal-Bellido; L.M. Marín-Gómez; G. Suárez-Artacho; J. Serrano-Díez-Canedo; J.M. Álamo-Martínez; F.J. Padillo-Ruiz; M.Á. Gómez-Bravo (Nov 2015). "Outcomes of Liver Transplantation During Adulthood After Kasai Portoenterostomy Due to Biliary Atresia".Transplant Proc.47(9): 2643–2644.doi:10.1016/j.transproceed.2015.09.058.PMID26680059.