Fig. 4

Porto-jejunostomy (also named as Kasai procedure) after left hemihepatectomy. It is used in complex cases with multiple bile duct stumps, which have small diameters and thin walls that can neither be plastic nor anastomosed separately. The figure shows that the posterior wall of bile duct stumps with surrounding tissue of Glisson pedicle have been sutured to the posterior wall of a single large anastomosis on the jejunum, and the anterior wall of the jejunal anastomosis is being anastomosed to hilar tissue