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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.


The week before your baby's surgery:

  • Tell your baby's surgeon about all medicines he or she currently takes. The surgeon will tell you if your baby should stop getting any medicine for surgery, and when to stop. He or she will tell you which medicines to give or not give your baby on the day of surgery.
  • Your baby may need blood, urine, or bowel movement tests before surgery. He or she may also need x-rays, an ultrasound, or scans liver and gallbladder scans. Talk to your baby's surgeon about these or other tests he or she may need. Write down the date, time, and location for each test.

The night before your baby's surgery:

  • Your baby will not be able to eat or drink for a number of hours before the surgery. Your baby's surgeon will tell you how many hours before to feed your baby. If you are breastfeeding, your baby's surgeon will give you specific instructions to follow.
  • Your baby's bowel may need to be emptied and cleaned out before the surgery. Healthcare providers may give him or her a liquid medicine called an enema. This will be put into your baby's rectum to help empty his or her bowels.

The day of your baby's surgery:

  • You or a close family member will be asked to sign a legal document called a consent form. It gives healthcare providers permission to do the procedure or surgery on your child. It also explains the problems that may happen, and your choices. Make sure all your questions are answered before you sign this form.
  • Give your baby only the medicines his or her surgeon told you to give.
  • Your baby will have an IV placed in a vein. He or she may be given liquids and medicine through the IV.
  • An anesthesiologist will talk to you before surgery. Your baby will be given general anesthesia to keep him or her asleep and free from pain during surgery. Tell him or her if your baby or anyone in his or her family had a problem with anesthesia.


What will happen:

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 get your baby out of bed until his or her surgeon says it is okay. He or she will then be taken to his or her hospital room.


  • Your baby has a fever.
  • Your baby has a cold or the flu.
  • You have questions or concerns about your baby's surgery.


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.

Care Agreement

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 (Precare)

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Further information

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