Kasai portoenterostomy (hepatic portoenterostomy) for biliary atresia achieves best outcomes when performed before which age?

• A 90 days of age
• B 60 days of age ✓
• C 6 months of age
• D 3 months of age

Explanation

The Kasai operation (hepatic portoenterostomy) creates a Roux-en-Y jejunal anastomosis to the hepatic hilum to allow bile drainage. Outcomes are strongly time-dependent: surgery before 60 days of life achieves bile drainage in up to 80% of cases and significantly delays or prevents progression to cirrhosis. After 90 days, ductal inflammation and fibrosis make satisfactory drainage increasingly unlikely. Infants who fail Kasai or present late will ultimately require liver transplantation, highlighting the importance of early diagnosis and referral.

Reference: Bailey & Love's Short Practice of Surgery, 27th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.