Brief Article
Copyright ©2011 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Oct 7, 2011; 17(37): 4231-4234
Published online Oct 7, 2011. doi: 10.3748/wjg.v17.i37.4231
Role of Kasai procedure in surgery of hilar bile duct strictures
Jin-Bo Gao, Li-Shan Bai, Zhi-Jian Hu, Jun-Wei Wu, Xin-Qun Chai
Jin-Bo Gao, Li-Shan Bai, Zhi-Jian Hu, Jun-Wei Wu, Xin-Qun Chai, Department of Hepatobiliary Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, Hubei Province, China
Author contributions: Gao JB and Chai XQ wrote the manuscript; Chai XQ designed the study; Chai XQ, Gao JB and Bai LS performed all of the procedures; and Hu ZJ and Wu JW analyzed the clinical data.
Correspondence to: Xin-Qun Chai, Professor, Department of Hepatobiliary Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, Hubei Province, China. xinqunc@hotmail.com
Telephone: +86-27-85351623 Fax: +86-27-85351623
Received: April 13, 2011
Revised: June 2, 2011
Accepted: June 9, 2011
Published online: October 7, 2011
Abstract

AIM: To assess the application of the Kasai procedure in the surgical management of hilar bile duct strictures.

METHODS: Ten consecutive patients between 2005 and 2011 with hilar bile duct strictures who underwent the Kasai procedure were retrospectively analyzed. Kasai portoenterostomy with the placement of biliary stents was performed in all patients. Clinical characteristics, postoperative complications, and long-term outcomes were analyzed. All patients were followed up for 2-60 mo postoperatively.

RESULTS: Patients were classified according to the Bismuth classification of biliary strictures. There were two Bismuth III and eight Bismuth IV lesions. Six lesions were benign and four were malignant. Of the benign lesions, three were due to post-cholecystectomy injury, one to trauma, one to inflammation, and one to inflammatory pseudotumor. Of the malignant lesions, four were due to hilar cholangiocarcinoma. All patients underwent Kasai portoenterostomy with the placement of biliary stents. There were no perioperative deaths. One patient experienced anastomotic leak and was managed conservatively. No other complications occurred perioperatively. During the follow-up period, all patients reported a good quality of life.

CONCLUSION: The Kasai procedure combined with biliary stents may be appropriate for patients with hilar biliary stricture that cannot be managed by standard surgical methods.

Keywords: Kasai procedure; Hilar bile duct; Stricture; Surgery