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Hepatic Portoenterostomy in Children


  • Hepatic portoenterostomy , also called Kasai's procedure, is a surgery done to treat biliary atresia. Biliary atresia is a serious liver and bile duct disease that is seen in infants. Normally, the liver makes bile, which is carried by the biliary tract to the intestines. The biliary tract is a network of channels and ducts. Bile flow from the liver and gallbladder going to the intestines (bowel) is affected in biliary atresia. The bile gets trapped and stored up in the liver, causing damage to the liver cells. Over time, this scarring may prevent blood flow through the liver and make it stop working permanently.
  • During the Kasai's procedure, a new duct is created where bile may pass from the liver into the intestine. Caregivers will first remove the gall bladder and damaged ducts. A new duct is made by sewing some parts of the small intestines directly to your baby's liver. Once the blocked ducts are removed and a new duct is made, a normal bile flow may be restored. Success is more likely if this surgery is done before the baby is two months old. With Kasai's procedure, your baby may be allowed to grow and live a normal life, and further problems prevented.



  • Keep a current list of your child's medicines: Include the amounts, and when, how, and why they are taken. Bring the list and the medicines in their containers to follow-up visits. Carry your child's medicine list with you in case of an emergency. Throw away old medicine lists. Give vitamins, herbs, or food supplements only as directed.
  • Give your child's medicine as directed: Call your child's healthcare provider if you think the medicine is not working as expected. Tell him if your child is allergic to any medicine. Ask before you change or stop giving your child his medicines.
  • Do not give aspirin to children under 18 years of age: Your child could develop Reye syndrome if he takes aspirin. Reye syndrome can cause life-threatening brain and liver damage. Check your child's medicine labels for aspirin, salicylates, or oil of wintergreen.
  • Antibiotics: This medicine is given to fight an infection caused by bacteria. Give your child this medicine exactly as ordered by his healthcare provider. Do not stop giving your child the antibiotics unless directed by his healthcare provider. Never save antibiotics or give your child leftover antibiotics that were given to him for another illness.
  • Pain medicine: Your child may need medicine to take away or decrease pain. Know how often your child should get the medicine and how much. Watch for signs of pain in your child. Tell caregivers if his pain continues or gets worse. To prevent falls, stay with your child to help him get out of bed.

Ask for more information about where and when to take your child for follow-up visits:

For continuing care, treatments, or home services for your child, ask for information.


A caregiver, called a dietitian, may talk to you about your baby's feeding and nutrition. A dietitian may increase the amount of calories your baby is getting. You may ask him if it is OK to breastfeed your baby or what milk you should feed him.

  • Ask your baby's caregiver about high-calorie liquid feedings. These are given through a tube called a nasogastric (NG) or orogastric (OG) tube. Ask your baby's caregiver how to give your baby these feedings.
  • Give your baby a good, well-balanced diet to help him feel better, have more energy, and heal faster. If your baby is able to eat normally, let him eat a variety of healthy foods. These may include fruits, vegetables, dairy products, or other baby foods.
  • Special formulas or oils may be added to your baby's foods or liquids. These may add extra calories to help him grow.


Your baby should rest as much as possible and get plenty of sleep.

Wound care:

When you are allowed to bathe your baby, carefully wash the incisions with soap and water. Afterwards, put on clean, new bandages. Change your baby's bandages any time they get wet or dirty. Ask your baby's caregivers for more information about wound care.


  • Your child has a fever.
  • Your baby is irritable and crying more than usual.
  • Your baby's skin is itchy, swollen, or has a rash.
  • You have any questions or concerns about your baby's disease, medicine, or care.


  • Your baby has more jaundice (yellowing of the skin or the whites of the eyes) than before.
  • Your baby has trouble breathing or his lips and fingernails are turning blue in color.
  • Your baby is not able to eat or drink, or urinating less or not at all.
  • Your baby is having a seizure (convulsion).
  • Your baby looks very weak or sleeps more than usual.
  • Your baby's vomit (throw up) has blood in it.
  • Your baby's wound or bandage has pus or a bad smell even if you are cleaning it everyday.

Learn more about Hepatic Portoenterostomy in Children (Aftercare Instructions)

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Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.