[Modified Kasai technique for the treatment of biliary atresia]

Kasai's procedure has changed significantly the prognosis of biliary atresia. However, ascending cholangitis is a relatively frequent postoperative complication with high morbidity and mortality rates. We have developed a modification of that technic consisting in the isolation of a segment of jejunum-with its blood supply carefully preserved, after fashioning an antireflux valve in its distal end. This segment of bowel, less than 10 cm. in length, is anastomosed to the porta hepatis proximally and to the duodenum distally. Using this technic, we have operated upon three infants with biliary atresia and a child with extended rabdosarcoma of the biliary tree. After a follow up of 10 to 17 months with an average of 12.5 months, all children remain free of cholangitis and two of them are anicteric.