title: Extramucosal hepaticojejunostomy.
abstract: 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.
authors.affiliation: Department of Surgery, Tom Baker Cancer Centre, University of Calgary, 1331 29th St. N.W., Calgary, Alberta, Canada T2N 4N2. Francis.Sutherland@CalgaryHealthRegion.ca
authors.forename: Francis
authors.initials: F
authors.lastname: Sutherland
authors.forename: Elijah
authors.initials: E
authors.lastname: Dixon
mesh_terms: 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
chemical_list: D016687:Polydioxanone