We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Article |

Long-term Results With the Kasai Operation for Biliary Atresia-Reply

Frederick M. Karrer, MD
Arch Surg. 1996;131(11):1235. doi:10.1001/archsurg.1996.01430230117026.
Text Size: A A A
Published online


The comments expressed in the communication from Lowell et al go right to the core of the biliary atresia controversy. Should the infants with this disease undergo a portoenterostomy or primary liver transplantation? While we acknowledge that the Kasai operation is an imperfect solution, the question is, how can we best identify those patients who are most likely to benefit from it? Unfortunately, our article1 was not intended to answer the question. However, our group has written numerous publications addressing prognostic factors in biliary atresia.2,3 We have demonstrated the prognostic importance of age at operation; bile duct histologic features; liver biopsy findings (fibrosis or cirrhosis, parenchymal degeneration, and giant cell transformation); and postoperative factors, such as bile drainage, cholangitis, portal vein velocity, variceal hemorrhage, and ascites. We chose in our article not to reiterate those previously published results but to focus our review on the long-term


Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview





Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.