Extramucosal hepaticojejunostomy.
BACKGROUND
The creation of a secure hepaticojejunostomy is an essential skill for any hepatobiliary surgeon.


METHODS
We describe a refined technique of sewing the end of the common hepatic duct to the side of the jejunum. The sutures are placed to include all layers of the bowel wall except mucosa.


RESULTS
One hundred eighty-five anastomoses were performed over a 6-year period. There were 3 documented leaks, 1 significant anastomotic bleed, and 2 postoperative strictures. There were no deaths.


CONCLUSIONS
This refined technique facilitates accurate placement of sutures by improving vision and results in a well-vascularized watertight connection.
Sutherland
Francis
F
Department of Surgery, Tom Baker Cancer Centre, University of Calgary, 1331 29th St. N.W., Calgary, Alberta, Canada T2N 4N2. Francis.Sutherland@CalgaryHealthRegion.ca
Dixon
Elijah
E
D000714:Anastomosis, Surgical / Q000379:methods; D006500:Hepatic Duct, Common / Q000601:surgery*; D006801:Humans; D007413:Intestinal Mucosa / Q000601:surgery*; D007583:Jejunum / Q000601:surgery*; D016687:Polydioxanone; D011446:Prospective Studies; D013536:Suture Techniques
D016687:Polydioxanone