What is Kasai surgery for congenital biliary atresia?

Congenital biliary atresia is a type of bile produced in the liver when the bile ducts inside and outside the liver are blocked.

Unable to pass into the intestines, leading to liver failure.

Depending on the location of the blockage, it can be divided into 3 types: Type 1 blockage occurs in the common bile duct.

The gallbladder contains bile; Type 2 obstruction is in the common hepatic duct, and the gallbladder does not contain bile but the lumen of the proximal bile duct contains bile; Type 3 hepatic hila.

Occlusion of the bile duct and absence of bile in the lumen of the proximal hepatic duct. Type 1 and Type 2 only require ordinary jejunal circuit reconstruction + bile duct-jejunal anastomosis (there used to be a lateral bile duct-jejunal anastomosis, but now there are fewer cases to do this), while type 3 requires Kasai surgery.

Type 3 Because the obstruction site is located in the hilum of the liver (the position is relatively high and cannot be anastomosed directly with the jejunum), it is necessary to first remove the fibrous tissue that causes biliary atresia in the hilar part of the liver, and then reconstruct the jejunal circuit, and then directly connect the hilum to the jejunum (pelvic anastomosis).

Because the intrahepatic bile duct in children is very thin, it is very unlikely that the intrahepatic bile duct and jejunum will be anastomostomosed, and even if one or two of them can be anastomosed, the other bile ducts will have complications such as bile leakage and narrowing of the intrahepatic bile duct and jejunal anastomosis.

Of course, this surgical method is not completely without drawbacks, first: bile still cannot be discharged into the intestine most or completely at all, and it needs to be operated again, and a liver transplant is required (this depends on the level of the surgeon, whether it is just right, and it has little to do with whether to give a red envelope, hehe). Second:

Retrograde cholangitis, the cause of this is unknown, but I think that the extrahepatic biliary tract of normal people is 7-9cm, and there is an Odys's sphincter when bile enters the intestine from the biliary duct.

Control. So duodenum.

The contents are less likely to enter the intrahepatic bile ducts. However, in patients who have undergone Kasai surgery, none of the above physiological anatomy, and the digestive juices and chyme in the intestine can easily enter the intrahepatic bile duct and induce cholangitis.

Congenital biliary atresia is a disease in which the bile ducts inside and outside the liver are obstructed and can lead to cholestatic cirrhosis and eventually liver failure, which is one of the most important digestive surgical diseases in the field of pediatric surgery and the most common indication for pediatric liver transplantation.

The surgical approach consists of three parts: 1) dissection of the hilar fibrous mass, which is probably the most important part; 2) jejunal circuit reconstruction; 3) Hepatojejunal anastomosis. The basic idea of Kasai's surgery is that even if the extrahepatic bile duct is closed, there may still be a small bile duct left near the hilum of the liver.

If the hilar fibrous mass can be appropriately removed, bile may be expelled smoothly.

Summary. Congenital biliary atresia, which accounts for half of all cases of long-term obstructive jaundice in neonates, occurs in 18,000 to 14,000 surviving infants, but varies greatly by region and ethnicity.

Congenital biliary atresia, biliary atresia, which accounts for half of the cases of long-term obstructive jaundice in neonates, is 18000-14000 surviving infants, but there are large regional and ethnic differences.

The majority of cases have been reported in Asia, with the incidence in Eastern ethnic groups being 4-5 times higher, and the male-to-female ratio is 1 to 2.

Congenital biliary atresia is a kind of obstruction of the bile ducts inside and outside the liver, which can lead to cholestatic cirrhosis Congenital biliary atresia and eventually liver failure.

The intolerance of biliary pyrolia peel is mainly based on surgery supplemented by drugs. Hepatic portojejunostomy (Kasai surgery) is the first choice of surgery, and if the child undergoes Kasai surgery within 3 months of age, the proportion of successful yellowing within 3 months is about 70% to 80%. If yellowing is not possible, liver transplantation should be considered.

If you don't plan to transplant a liver, how long can you live if you are conservative?

If congenital biliary atresia is not undertaken, the survival time may be as low as one year without any surgery**.

Fever, big belly, little urine and less stool, black loose stool, where is this?

This is a serious condition, and if you don't seek medical attention in time, the patient will die from a biliary tract infection.

Generally, there is anorexia, dyspepsia, with the development of the disease, jaundice, fever, abdominal pain, abdominal mass, and jaundice gradually deepened, and there are clay-colored stools, all of which are symptoms of biliary obstruction. Some patients will also have blood in the stool, hematemesis, cholestasis, hepatic ascites, and even liver function decompensation, liver cirrhosis and filial piety, and splenomegaly, all of which are a chain reaction.

Summary. Congenital biliary atresia should be surgically treated as soon as possible**, and drugs** can only alleviate the progression of the disease, but cannot be effective**. Congenital biliary atresia occurs in the embryonic stage, mostly due to viral infection, resulting in biliary closure, preventing the liver from secreting bile into the gallbladder, and long-term cholestasis leads to damage to liver function, thereby inducing acute liver failure and endangering the life of the baby.

Patients present with progressively worsening jaundice, dark yellow urine, and white clay-like stools. Children with congenital biliary atresia should undergo prompt surgery**, including portojejunostomy or liver transplantation. In addition, taking ursodeoxycholic acid as directed by your doctor can help with bile excretion, but it does not cause disease.

If it is not effective**, cirrhosis and liver failure can lead to death within two years of life.

How is the type of biliary atresia determined?

Congenital biliary atresia should be surgically treated as soon as possible**, and drugs** can only alleviate the progression of the disease, but cannot be effective**. Congenital biliary atresia occurs in the embryonic stage, and most of the subdued states are caused by viral infection, resulting in biliary closure, preventing the liver from secreting bile into the gallbladder, and long-term cholestasis leads to damage to liver function, thereby inducing acute liver failure and endangering the life of infants. Patients present with progressively worsening jaundice, dark yellow urine, and white clay-like stools.

Children with congenital biliary atresia should undergo prompt surgery**, including portojejunostomy or liver transplantation. In addition, taking ursodeoxycholic acid as directed by your doctor can help with bile excretion, but it does not cause disease. If it is not effective**, it will be complicated by cirrhosis and liver failure leading to death within two years of life.

Congenital biliary atresia has total atresia, that is, the entire biliary tract is underdeveloped and completely atresia; The second is that the proximal biliary tract is atresia but the distal biliary tract is normal; The third is that the proximal biliary tract is unobstructed, but the distal bile is atresia. If it is proximal biliary atresia, the effect after surgery is relatively ideal, so after intrahepatic bile duct atresia, liver transplantation may often be required to solve the problem. One of the most common surgeries performed for biliary atresia is called Kasai surgery, in which the jejunum is directly anastomosed to the hilar part of the liver.

After surgery, there are about 1 3 patients who are more ideal; 1 3 patients may only be in the transition period and have not yet fully achieved biliary patency; There are another 1 3 who may have poor results and may eventually be considered for liver transplantation.

Hello: If your child is clearly diagnosed with congenital biliary atresia, liver transplantation may be the most effective means, requiring the child's parents or grandparents and other immediate family members to provide part of the liver for the child under the premise of matching blood type and passing the examination.

What is your child's current examination status (including the child's weight and liver function indicators), I hope you can upload the relevant examination information, and then give you suggestions after the evaluation!

Congenital biliary atresia is mainly manifested by obstructive jaundice, nutritional and dysplasia, hepatosplenomegaly and other symptoms. Obstructive jaundice is the most prominent manifestation of this congenital biliary atresia of the previous type, usually manifested by the baby** sclera turning greenish-brown or dark green, dark brown urine and clay-colored stools. When biliary atresia reaches about 4 months, infants will be malnourished and unresponsive.

As the disease progresses, the liver also enlarges, and portal hypertension develops, which gradually deteriorates, and in severe cases, death. After the diagnosis of biliary atresia is confirmed, surgery is the only effective method to delay the life of some children, and surgery is most suitable for 2 months. If the operation is too late, the child will have developed biliary cirrhosis, and the prognosis will be extremely poor.