Historical vignette
Morio Kasai: a remarkable impact beyond the Kasai procedure

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Abstract

Morio Kasai is one of the most influential Japanese pediatric surgeons. He is best recognized in the United States for his pioneering efforts in the field of biliary atresia. His work revolutionized the treatment of infants born with biliary atresia throughout the world. Less is known about his remarkable impact in the fields of general surgery and pediatric surgery. This review highlights some of Dr Kasai's major contributions and highlights the influence he had in the establishment of pediatric surgery as a field.

Section snippets

Education, professional, and personal life

Dr Kasai was born in 1922, in Aomori Prefecture, the northernmost prefecture of the mainland of Japan, far from Tokyo, the longstanding center of medical and political life in Japan. He began his medical studies in Sendai at the end of World War II, during a time of economic hardship and social changes in Japan. He graduated from the National Tohoku University School of Medicine in 1947 and remained at Tohoku University for his surgical training and then joined what was known as the second

The Kasai procedure

Dr Kasai's reputation in the western hemisphere has been based primarily on his many contributions to the knowledge and therapeutic advancements in the area of biliary atresia, improving the care and outcomes for children afflicted with this rare disorder. Biliary atresia is a serious condition affecting infants with an incidence of 1 in 15,000 live births and is the most common surgical cause of neonatal jaundice [7]. It is characterized by an obliterative cholangiopathy that affects all or

Other surgical contributions

Early in his career, Dr Kasai became interested in pediatric oncology, and his studies of the histopathology and surgical treatment of pediatric liver tumors proved to be seminal in that field when originally presented [13]. He and his colleagues are credited with devising one of the first pathologic classification systems for hepatoblastoma, the most common primary liver tumor in childhood [14].

Dr Kasai also investigated methods to improve the established management of children with

A legacy of distinction

Later in his career, Dr Kasai focused on the importance of clinical research and on unifying the research studies in the field of pediatric surgery throughout Japan and eventually throughout the world. To this end, Dr Kasai founded several scientific associations, many of which continue to advance his vision of pediatric surgery as a central and distinct division within general surgery. He was the founder or helped to create the Japanese Society of Pediatric Surgeons, the Japanese Society for

Conclusion

Dr Kasai is well recognized as one of the most influential Japanese surgeons by his contributions to pediatric and general surgery and to the field of surgical education and research. His influence on surgical practice, particularly in pediatric surgery, continues to be felt today across the globe through his pioneering contributions to treatment of children afflicted with biliary atresia. The Kasai procedure remains the gold standard in the initial surgical management for infants with biliary

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1

Alejandro Garcia was a recipient of a T32 training grant (HL007343) from the NIH.

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