title: Successful salvage of late failure of hepatic portocholecystostomy (gallbladder Kasai) with Roux-en-Y cholecystojejunostomy.
abstract: The hepatic portoenterostomy (HPE) is the accepted initial operation for biliary reconstruction for biliary atresia, but in a select group of patients with patent distal extrahepatic bile ducts (PDEBD), a hepatic portocholecystostomy (HPC) may also be considered. A10 year old boy presented with sudden onset of jaundice following a successful HPC at 2 months of age. Radiographic evaluation revealed excretion into a distended gallbladder with distal biliary obstruction. He underwent a successful Roux-en-Y cholecystojejunostomy and remains jaundice-free two years later. Cholecystojejunostomy is an effective salvage operation for patients who develop late distal biliary obstruction after an HPC.
authors.affiliation: Department of Surgery, Kaiser Permanente, 4760 Sunset Boulevard, 3rd Floor, Los Angeles, CA 90027, USA.
authors.forename: Michael S
authors.initials: MS
authors.lastname: Tam
authors.forename: Donald B
authors.initials: DB
authors.lastname: Shaul
authors.forename: Roman M
authors.initials: RM
authors.lastname: Sydorak
mesh_terms: D001656:Biliary Atresia / Q000601:surgery*; D002648:Child; D002767:Cholecystostomy / Q000379:methods*; D006801:Humans; D007582:Jejunostomy / Q000379:methods*; D008099:Liver / Q000601:surgery; D008297:Male; D012074:Remission Induction; D013997:Time Factors; D017211:Treatment Failure