Congenital absence or closure of the bile ducts, biliary atresia, is a disease state of unknown etiology, controversial definition, and, until recently, no effective therapy. It is a condition of newborns, most commonly female newborns, and Western methods of treatment have achieved a survival rate no greater than seven percent.

Daniel Hays and Ken Kimura now make available a comprehensive study of radical methods developed in japan which have achieved dramatically more encouraging results over the last twenty-five years. Western and Japanese approaches are compared and contrasted with respect to differential diagnosis, methods of classification, surgical technique, results, complications, and long-range survival. The largely skeptical attitudes of Western surgeons are also examined with revealing insight. While the writing is always temperate, the facts themselves argue most eloquently for a closer appraisal of this option for treating an otherwise fatal disease.