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Hepatic Portoenterostomy in Infants


Hepatic portoenterostomy, or Kasai procedure, is surgery to treat biliary atresia. Biliary atresia is a blockage of the bile ducts (tubes) that carry bile from the liver to the gallbladder. Bile is a liquid made by the liver that helps with digestion.


Before your baby's surgery:

  • Informed consent is a legal document that explains the tests, treatments, or procedures that your child may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your child's medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done to your child. Make sure all of your questions are answered.
  • An IV will be put in a vein. Your baby may get liquid or medicines through the IV.
  • General anesthesia will keep your baby asleep and free from pain during surgery. Anesthesia may be given through your baby's IV. He or she may instead breathe it in through a mask or a tube placed down his or her throat. The tube may cause your baby to have a sore throat when he or she wakes up.

During your baby's surgery:

Your baby's surgeon will make an incision on the upper right side of your baby's abdomen. He or she will remove the blocked bile ducts. Your baby's liver will be connected to his or her small intestine. This creates a new duct to drain bile from your baby's liver. Your baby's surgeon may inject a dye to check for any leaks in the new duct. The incision will be closed with stitches or staples. A bandage will be placed over the incision.

After your baby's surgery:

Your baby will be taken to a room to rest until he or she is fully awake. He or she will be monitored closely for any problems. Do not let your baby get out of bed until his or her healthcare provider says it is okay. He or she will then be taken to his or her hospital room.

  • Extra oxygen may be needed if your baby's blood oxygen level is lower than it should be. Your baby may get oxygen through small tubes placed in his or her nostrils or through a mask. Do not remove your baby's oxygen without asking his or her healthcare provider first.
  • Blood or bowel movement tests may be needed to check liver function or how much bile comes out in your baby's bowel movement.
  • Medicines:
    • Antibiotics help prevent or treat a bacterial infection.
    • Pain medicine may be given.
    • Antinausea medicine may be given to calm your baby's stomach and help prevent vomiting.
    • Anti-itch medicine may help prevent or treat itchy skin.
    • Biliary medicines, or choleretics, decrease the amount of fat released by the liver into the bile.
    • Diuretics help decrease extra fluid in your baby's abdomen. He or she may urinate more often while taking this medicine.
    • Vitamin supplements or special formula may be given to make sure your baby is getting enough nutrition.


Your baby may bleed more than expected or get an infection. Pressure or fluid may build up in his or her blood vessels or abdomen. Your baby may have an increased risk for poor nutrition and growth. His or her liver may scar or stop working properly. The new duct may stop working and your baby may need another surgery.


You have the right to help plan your baby's care. Learn about your baby's health condition and how it may be treated. Discuss treatment options with your baby's healthcare providers to decide what care you want for your baby.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Learn more about Hepatic Portoenterostomy in Infants (Inpatient Care)

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