Kasai-Like Hepaticojejunostomy As Salvage Reconstruction for Bile Duct Injury in an Infant: A Case Report and Technical Consideration

Bile duct injury (BDI) in children is an uncommon yet serious complication after hepatobiliary surgery or trauma. Management is particularly challenging because of the extremely small caliber of infantile bile ducts, which makes conventional biliary reconstruction technically difficult. Standard approaches are often not feasible when the injury occurs at the hilar level or involves ultra-thin ducts. In such cases, alternative surgical strategies are required. A Kasai-like hepaticojejunostomy- an approach analogous to the portoenterostomy used in biliary atresia- may serve as a salvage option when standard hepaticojejunostomy is technically impossible. We report a one-year-old boy with multiple congenital anomalies and hepatoblastoma involving segments 4 and 6 who underwent right hepatic trisectionectomy. During hilar dissection, an inadvertent pin-hole injury to the common bile duct (