Skip to Content

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 child'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 is a small tube placed in your child's vein that is used to give him medicine or liquids.
  • General anesthesia will keep your child asleep and free from pain during surgery. Anesthesia may be given through your child's IV. He may instead breathe it in through a mask or a tube placed down his throat. The tube may cause your child to have a sore throat when he wakes up.

During your child's surgery:

Your child's surgeon will make an incision on the upper right side of your child's abdomen. He will cut and remove the blocked bile ducts. Your child's surgeon will connect your child's liver to his small intestine. This creates a new duct to drain bile from your child's liver. Your child'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 child's surgery:

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

  • Extra oxygen may be needed if your child's blood oxygen level is lower than it should be. Your child may get oxygen through small tubes placed in his nostrils or through a mask. Do not remove your child's oxygen without asking his healthcare provider first.
  • Blood or bowel movement tests may be needed to check liver function or how much bile comes out in your child's bowel movement.
  • Your child will be able to eat and drink gradually after surgery. Your child will begin with water, followed by breast milk, formula, or juice. If your child's stomach does not become upset, he may eat applesauce, mashed fruits and vegetables, or other baby foods.
  • Medicines:
    • Antibiotics help prevent or treat a bacterial infection.
    • Pain medicine will decrease your child's pain. Do not wait until your child's pain is severe before you ask for more medicine.
    • Antinausea medicine may be given to calm your child'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 child's abdomen. He may urinate more often.
    • Vitamin supplements or special formula may be given to make sure your child is getting enough nutrition.


Your child may bleed more than expected or get an infection. Your child may develop increased pressure in his blood vessels or fluid buildup in his abdomen. You child hay have an increased risk for poor nutrition and growth. Your child's liver may scar or stop working properly. The new duct may stop working and your child 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 caregivers to decide what care you want for your baby.

© 2016 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

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.