Brunner Maximilian, Grützmann Robert
Klink für Allgemein- und Viszeralchirurgie, Universitätsklinikum der Friedrich-Alexander-Universität Erlangen, Erlangen, Deutschland.
, Krankenhausstr. 12, 91054, Erlangen, Deutschland.
Chirurgie (Heidelb). 2025 Sep 9. doi: 10.1007/s00104-025-02372-2.
The biliodigestive anastomosis represents a core element of hepatopancreatobiliary surgery. It requires a precise surgical technique and detailed knowledge of biliary anatomy and vascular supply. A tension-free suture, sufficient perfusion of the anastomosed structures and an exact mucosa-to-mucosa adaptation using delicate absorbable suture material are decisive for a successful construction. Hepaticojejunostomy has become established as the gold standard for a biliodigestive anastomosis. Currently available studies show no significant differences in morbidity between open and minimally invasive techniques, whereby the latter is becoming increasingly more important. There was also no difference in the clinical results with respect to the suture technique (interrupted vs. continuous suture); however, the continuous suture technique is associated with a shortening of the placement time and a reduction in costs. Complications after biliodigestive anastomosis, such as insufficiency and stenosis, are clinically relevant and substantially influence the morbidity and mortality; however, many of these complications can nowadays be effectively treated by interventional procedures.
胆肠吻合术是肝胰胆外科手术的核心组成部分。它需要精确的手术技巧以及对胆道解剖结构和血管供应的详细了解。无张力缝合、吻合结构的充分灌注以及使用精细可吸收缝合材料实现精确的黏膜对黏膜贴合，对于成功构建吻合至关重要。肝空肠吻合术已成为胆肠吻合术的金标准。目前的研究表明，开放手术和微创技术在发病率方面无显著差异，而微创技术正变得越来越重要。在缝合技术（间断缝合与连续缝合）方面，临床结果也没有差异；然而，连续缝合技术可缩短缝合时间并降低成本。胆肠吻合术后的并发症，如吻合口漏和狭窄，具有临床相关性，并对发病率和死亡率有重大影响；然而，如今许多此类并发症可通过介入治疗得到有效处理。
