Table 1: Modifications of the traditional Kasai hepato-porto-enterostomy.

Wide dissection of the biliary remnant

Hashimoto modification: Extension of the lateral dissection into segmental bifurcations of the portal vein, followed by trimming the liver with the CUSA [66]
Suzuki modification: Trimming of the segment 4 of the liver with the CUSA [68]

Prevention of cholangitis

Antireflux valve:Ando modification: Better exposition of the biliary remnant, by dividing the ligamentum venosum (Arantius’ remnant) [69]
Nakajo modification: Confection of an 2-cm long antireflux valve by invaginating the proximal intestinal portion of the Roux-en-Y limb into its denuded distal portion [75].
Enteric conduit:Kasai II-operation: Creation of a double-Y, where the proximal part of the Roux-en-Y limb is exteriorized through the abdominal wall; the distal segment is end-to-side anastomosed to this proximal segment for continuity of the bile flow [80].
Sawaguchi modification: Complete exteriorization of the entire Roux-en-Y limb as a jejunostomy [81]
Suruga modification: Double-barrel ostomy of the Roux-en-Y limb [84]
Endo modification: Anastomosis of an ileocolic conduit to the porta hepatis, and exteriorization of the ascending colon as a colostomy including the ileocecal valve [64]