Guest guest Posted August 4, 2006 Report Share Posted August 4, 2006 Hi Chris; I don't know too much about this, but I'll do my best to answer your questions. A good article on Biliary Atresia can be found at: www.cincinnatichildrens.org/svc/alpha/l/liver/diseases/biliary.htm It includes a section on hepatoportoenterostomy (or Kasai procedure): _________________________ How is biliary atresia treated? Biliary atresia cannot be treated with medication. A Kasai procedure or hepatoportoenterostomy is done. The Kasai procedure is an operation to create an open duct so bile can drain from the liver. It is named after the surgeon who developed it. The surgeon removes the damaged ducts outside of the liver (extrahepatic ducts) and replaces them with a piece of the baby's own intestine. This new duct allows bile to pass from the liver into the intestine. After this procedure, infants are usually in the hospital for 7 to 10 days to heal. Medications are used to prevent excessive fluid build-up in the abdomen (ascites). Long-term antibiotic therapy is also given to reduce the risk of infection. With an experienced surgeon, the Kasai procedure is successful in 60 to 85 percent of the patients. This means that bile drains from the liver and the jaundice goes down. The Kasai procedure is not a cure for biliary atresia, but it does allow babies to grow and have fairly good health for several years. When this procedure does not work, it is usually because the blocked bile ducts are inside the liver (intrahepatic), as well as outside the liver (extrahepatic). If this is the case, liver transplantation can correct this problem. Success with this procedure is related to: Age. Surgery is most successful in infants younger than two to three months of age. Extent of liver damage (cirrhosis) at the time of surgery. The number and size of microscopic ducts in the scarred tissue that can drain bile. The experience of the surgical and medical team. Centers with teams made up of specialists with extensive experience have success rates that are greater than those centers with less experienced teams. _____________________ As indicated in this article, the surgery is only successful if the blocked bile ducts are outside the liver (i.e. extrahepatic). They cannot replace blocked bile-ducts inside the liver (intrahepatic) with this procedure! As I understand it, PSC in adults can involve blockages of both intrahepatic and extrahepatic ducts, and most often the extrahepatic duct blockages are managed by ERCP with balloon dilitation or stenting, rather than by Kasai procedures. Best regards, Dave (father of (21); PSC 07/03; UC 08/03) > Hi All (?), Can anyone tell me anything about the Kasai (also know as the hepatoportoenterostomy) procedure? It seems it is only done for very young infants and children with biliary atresia. Is this an appropriate procedure for the treatment of PSC? Has it been done and been successful in adults with PSC? Chris Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 7, 2006 Report Share Posted August 7, 2006 .... PSC in adults can involve blockages of both intrahepatic and extrahepatic ducts, and most often the extrahepatic duct blockages are managed by ERCP with balloon dilitation or stenting, rather than by Kasai procedures... , Thank you - Right... ERCP, dilation, stenting, medical management with Urso, fish oil, something to control the itching, antibiotics when needed, dietary supplements and vitamins, ultimately liver transplant... and pray to God no adenocarcinoma. I am still wondering why on earth my son's GI doc would have even broached the subject of the Kasai procedure with our family. I am trying to understand if this doc knows something cutting-edge, or if he is out in left field somewhere. Chris mother of Joe (32) UC 1987, J-pouch 1999, PSC, acute pancreatitis 3/06 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 7, 2006 Report Share Posted August 7, 2006 .... PSC in adults can involve blockages of both intrahepatic and extrahepatic ducts, and most often the extrahepatic duct blockages are managed by ERCP with balloon dilitation or stenting, rather than by Kasai procedures... , Thank you - Right... ERCP, dilation, stenting, medical management with Urso, fish oil, something to control the itching, antibiotics when needed, dietary supplements and vitamins, ultimately liver transplant... and pray to God no adenocarcinoma. I am still wondering why on earth my son's GI doc would have even broached the subject of the Kasai procedure with our family. I am trying to understand if this doc knows something cutting-edge, or if he is out in left field somewhere. Chris mother of Joe (32) UC 1987, J-pouch 1999, PSC, acute pancreatitis 3/06 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 7, 2006 Report Share Posted August 7, 2006 .... PSC in adults can involve blockages of both intrahepatic and extrahepatic ducts, and most often the extrahepatic duct blockages are managed by ERCP with balloon dilitation or stenting, rather than by Kasai procedures... , Thank you - Right... ERCP, dilation, stenting, medical management with Urso, fish oil, something to control the itching, antibiotics when needed, dietary supplements and vitamins, ultimately liver transplant... and pray to God no adenocarcinoma. I am still wondering why on earth my son's GI doc would have even broached the subject of the Kasai procedure with our family. I am trying to understand if this doc knows something cutting-edge, or if he is out in left field somewhere. Chris mother of Joe (32) UC 1987, J-pouch 1999, PSC, acute pancreatitis 3/06 Quote Link to comment Share on other sites More sharing options...
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