Department of Digestive and Transplantation Surgery, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan;
Department of Surgery, Keio Univeristy School of Medicine, Tokyo, Japan.
Anticancer Res. 2024 Jan;44(1):167-171. doi: 10.21873/anticanres.16799.
BACKGROUND/AIM: Although hepaticojejunostomy is a relatively uncomplicated surgical procedure, its postoperative complications can range from a prolonged hospital stay to death. In hepatectomy, including resection of the perihilar bile duct for perihilar cholangiocarcinoma, the difficulty of performing hepaticojejunostomy and the complication rate increase due to the characteristics of surgery required for perihilar cholangiocarcinoma. In this study, we standardized the interrupted parachute suture technique and examined its safety and efficacy.
The greatest advantage of our technique is the use of interrupted sutures, and the anterior bile duct is threaded prior to completing the posterior anastomosis. Therefore, the field of vision is better when threading the bile duct and intestinal tract, and the needle handling procedure can be performed relatively stress-free regardless of the type of hepatectomy.
In patients who underwent hepaticojejunostomy, postoperative biliary complications, such as anastomotic leakage, biliary stricture, hemobilia, and jejunal bleeding, were not observed.
The interrupted suture is easy to implement in biliary reconstruction and can facilitate any type of hepatic resection. In addition, the standardized technique was efficient and safe and did not increase the incidence of postoperative complications.
背景/目的：尽管胆肠吻合术是一种相对简单的手术，但它的术后并发症范围从延长住院时间到死亡。在肝切除术，包括肝门胆管癌的肝门胆管切除，由于肝门胆管癌所需手术的特点，胆肠吻合术的难度和并发症发生率增加。在这项研究中，我们标准化了间断降落伞缝合技术，并检查了其安全性和有效性。
我们技术的最大优势是使用间断缝合，并且在完成后吻合之前穿通前胆管。因此，在穿通胆管和肠道时视野更好，并且无论肝切除术的类型如何，针处理程序都可以相对轻松地进行。
在接受胆肠吻合术的患者中，未观察到术后胆漏、胆管狭窄、出血性胆血症和空肠出血等胆肠吻合术并发症。
间断缝合在胆道重建中易于实施，并可以促进任何类型的肝切除术。此外，标准化技术高效且安全，不会增加术后并发症的发生率。
