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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 child's surgery:

  • Write down the date, time, and location of your child's surgery.
  • When you take your child to see his healthcare provider, bring a list of his medicines or the medicine bottles. Tell healthcare providers if your child uses herbs, food supplements, or over-the-counter medicine. If your child is allergic to any medicine, tell his healthcare provider.
  • Ask your child's healthcare provider if your child needs to stop using certain medicines before his surgery.
  • Your child may need blood, urine, or bowel movement tests before his surgery. He may also need x-rays, an ultrasound, or scans of his liver and gallbladder. Talk to your child's healthcare provider about these or other tests he may need. Write down the date, time, and location for each test.

The night before your child's surgery:

  • Ask healthcare providers about directions for eating and drinking.
  • Your child's bowel may need to be emptied and cleaned out before the surgery. Healthcare providers may give him a liquid medicine called an enema. This will be put into his rectum to help empty his bowel.

The day of your child's surgery:

  • Ask before you give your child any medicine on the day of his surgery. Bring your child's pill bottles or a list of all the medicines he takes with you to the hospital.
  • 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.
  • Your child will have an IV tube placed in a vein. He may be given liquids and medicine through the IV.
  • An anesthesiologist will talk to you and your child before the surgery. Your child may need medicine to keep him asleep or numb an area of his body during surgery. Tell healthcare providers if anyone in your family has had a problem with anesthesia in the past.


What will happen:

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.


  • Your child cannot make it to his surgery.
  • Your child has a fever.
  • Your child has a cold or the flu.
  • You have questions or concerns about your child's surgery.

Seek Care Immediately if

  • Your child's symptoms get worse.


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.

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.

Further information

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

Learn more about Hepatic Portoenterostomy in Infants (Precare)

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