ABSTRACT
Surgical exploration was increasingly advocated from the 1930s and the terms “correctable” and “non-correctable” became prevalent to describe what could be done with a conventional surgical operation (e.g. hepaticojejunostomy). However, as most cases of biliary atresia (BA) were anatomically “non-correctable” at that time, their outlook was poor and true survivors were exceptional. BA remains a rare disease with a frequency of between 1 in 10 000 and 1 in 20 000 live births. It is more common in Japan and China than in Europe or North America, although the reasons are not apparent. Many alternatives have been proposed since Kasai's original description, with the drift being to a more radical dissection aiming to excise all extrahepatic bile duct tissue within and between the vascular pedicles and incorporating this into a wide anastomosis. The laparoscopic dissection described here is deliberately abbreviated to transecting the cone leaving an ovoid remnant.
