Kasai portoenterostomy performed for Extrahepatic biliary atresia has greatly improved the prognosis of infants with biliary atresia and the results of surgical treatment have improved steadily over the past few years.
Laparoscopic portoenterostomy was not regarded as a beneficial procedure, and was abandoned by the International Pediatric Endosurgery Group in 2007.
Laparoscopic portoenterostomy is being performed with encouraging results after the open extended portoenterostomy procedure currently performed was revised to more closely resemble the original procedure developed by Kasai in the 1950s. Thus, the risk for damage to micro bile ducts around the porta hepatis is minimized because deep suturing and extensive dissection are eliminated.
Hepaticojejunostomy is recommended for correctable Biliary atresia (BA) with proximal common hepatic duct diameter not less than 0.5 cm. Under the laparoscope, the Biliary Atresia classification can be confirmed by the cholangiogram. Moreover, hepaticojejunostomy can be achieved for correctable BA. This can also be easily converted to open Kasai portoenterostomy for uncorrectable BA.