title: Hepaticojejunostomy with the "Hand-Fan" technique.
abstract: A standard hepaticojejunostomy technique might be difficult to perform, especially when the bile duct is small and located deep in the liver hilum. Herein we present a new procedure, the Hand-Fan technique, that was used to enhance the exposure and ease the performance of these challenging anastomoses. Thirty-one patients who had had hepaticojejunostomy with this technique for bile duct injury and other benign biliary pathologies from July 2004 to June 2011 were included into the study. Median postoperative hospital stay was 7 days (6-25 days) and median follow-up time was 33 months (2-84 months). Liver function tests revealed that the blood bilirubin levels of the patients were normalized after hepaticojejunostomy. Follow-up showed that there were no signs of clinical recurrence or impaired bile flow. The Hand-Fan technique considerably facilitates challenging hepaticojejunostomies. Surgeon's comfort is exceptional and the clinical results are satisfactory.
authors.affiliation: Department of General Surgery, Division of Hepatopancreatobiliary Surgery, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey.
authors.forename: Salih
authors.initials: S
authors.lastname: Pekmezci
authors.forename: Kaya
authors.initials: K
authors.lastname: Saribeyoglu
authors.forename: Erman
authors.initials: E
authors.lastname: Aytac
authors.forename: Buket
authors.initials: B
authors.lastname: Serdar
mesh_terms: D000328:Adult; D000368:Aged; D000713:Anastomosis, Roux-en-Y / Q000009:adverse effects; D001660:Biliary Tract Diseases / Q000097:blood / Q000175:diagnosis / Q000601:surgery*; D001662:Biliary Tract Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D001663:Bilirubin / Q000097:blood; D015415:Biomarkers / Q000097:blood; D005260:Female; D006801:Humans; D007582:Jejunostomy / Q000009:adverse effects; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D001663:Bilirubin