title: Reconstruction of small bile ducts using a parachute technique.
abstract: Benign or malignant stricture of extrahepatic bile ducts may result when small intrahepatic bile ducts are anastomosed to the jejunal loop after resection of extrahepatic bile ducts, hepatic parenchyma, and intrahepatic bile ducts. We applied a parachute technique, which has been used for fine vascular anastomosis, to hepaticojejunostomy in eight patients with either extrahepatic bile duct carcinoma or intrahepatic cholangiocellular carcinoma. One to four small bile ducts were anastomosed to the jejunal loop. No patient experienced a complication due to this anastomosis. Postoperative elevation of the serum bilirubin was transient, and all patients were discharged within 36 days after surgery. Although the follow-up period in this series is not yet long enough to evaluate the long-term outcome of this technique, the ease of the hepaticojejunostomy and good short-term results warrant farther clinical investigation of this technique.
authors.affiliation: Department of Surgery, Ibaraki Prefectural Central Hospital and Cancer Center, 6528 Koibuchi, Tomobe-machi, Ibaraki 309-1793, Japan. f-yoshimi@chubyoin.pref.ibaraki.jp
authors.forename: Fuyo
authors.initials: F
authors.lastname: Yoshimi
authors.forename: Mami
authors.initials: M
authors.lastname: Ikeda
authors.forename: Daiji
authors.initials: D
authors.lastname: Oka
authors.forename: Yuji
authors.initials: Y
authors.lastname: Asato
mesh_terms: D000368:Aged; D000714:Anastomosis, Surgical / Q000379:methods; D001650:Bile Duct Neoplasms / Q000601:surgery; D001653:Bile Ducts, Intrahepatic / Q000601:surgery*; D001662:Biliary Tract Surgical Procedures / Q000379:methods*; D018281:Cholangiocarcinoma / Q000601:surgery; D005260:Female; D006801:Humans; D007583:Jejunum / Q000601:surgery; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000379:methods