Error Traps and Culture of Safety in Biliary Atresia
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In brief
In brief
Practice guideline for optimizing biliary atresia outcomes through timely hepatoportoenterostomy (Kasai procedure) with minimal complications. Reviews surgical technique refinements and perioperative management strategies developed over 50 years to maximize native liver survival in neonates with this progressive bile duct disease.
Written by the GCMD Library team from the article.
Publication date: Available online 25 April 2019
Source: Seminars in Pediatric Surgery
Author(s): Frederick M. Karrer, Jonathan P. Roach
Abstract
Biliary atresia is a progressive inflammatory sclerosing disease of the bile ducts in the neonatal liver. Without surgical intervention these patients are destined to succumb to the disease. The development of the hepatoportoenterostomy in 1959 and liver transplantation in 1963 ushered a new era of success treating these patients. While many surgical modifications and adjuncts to treatment have been attempted over the last 50 years, the mainstay of treatment to give the child the best chance at prolonged survival with the native liver is a properly performed operation, in a timely fashion, with minimal post-operative complications. This review presents the authors current practice guideline to achieve these goals.