The Kasai portoenterostomy for biliary atresia is most likely to achieve bile flow and delay transplantation when performed before what age?

• A Before 60 days of life ✓
• B Before 30 days of life
• C Before 90 days of life (3 months)
• D Before 6 months of life

Explanation

The Kasai hepatic portoenterostomy has the highest success rate in establishing bile drainage (and thus delaying or avoiding liver transplantation) when performed before 60 days of age, with approximately 70–80% achieving bile flow. After 90 days, the success rate falls to below 25% due to progressive intrahepatic biliary injury and fibrosis. Early diagnosis by the screening stool colour chart (introduced in Japan and Taiwan) enables timely surgery. Even after successful Kasai, 70–80% of patients eventually require liver transplantation by adulthood.

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.