CPT® Code 47701

Portoenterostomy, commonly referred to as the Kasai procedure, is a surgical intervention primarily aimed at addressing congenital biliary atresia. This condition is characterized by the obstruction or absence of the extrahepatic bile ducts, which are essential for the proper drainage of bile from the liver. When biliary atresia is left untreated, it can lead to severe complications, including cirrhosis and irreversible liver damage. The procedure involves making an incision in the upper midline of the abdomen to access the gallbladder and liver. During the operation, the surgeon meticulously dissects the hilum of the liver to locate the remnant of the biliary tract. The jejunum, a part of the small intestine, is then mobilized and divided to create a Roux-en-Y limb. This limb is crucial as it allows for the anastomosis, or surgical connection, of the distal end of the jejunum to the liver hilum, facilitating bile drainage. The proximal end of the jejunum is also anastomosed to the side of the jejunum, ensuring continuity of the intestinal tract. To manage any potential postoperative complications, drains may be placed as necessary before the abdomen is closed. This procedure is vital for improving bile flow and preventing further liver damage in affected patients.