Cluster hepaticojejunostomy with radial spreading anchoring traction technique for secure reconstruction of widely opened hilar bile ducts
Korean Journal of Hepato-Biliary-Pancreatic Surgery
; : 66-70, 2016.
Article
in En
| WPRIM
| ID: wpr-81488
Responsible library:
WPRO
ABSTRACT
Secure reconstruction of multiple hepatic ducts that are severely damaged by tumor invasion or iatrogenic injury is a challenge. Failure of percutaneous or endoscopic biliary stenting requires lifelong placement of one or more percutaneous transhepatic biliary drainage (PTBD) tubes. For such difficult situations, we devised a surgical technique termed cluster hepaticojejunostomy (HJ), which can be coupled with palliative bile duct resection. The cluster HJ technique consisted of applying multiple internal biliary stents and a single wide porto-enterostomy to the surrounding connective tissues. The technique is described in detail in the present case report. Performing cluster HJ benefits from three technical tips as follows: making the multiple bile duct openings wide and parallel after sequential side-to-side unification; radially anchoring and traction of the suture materials at the anterior anastomotic suture line; and making multiple segmented continuous sutures at the posterior anastomotic suture line. Thus, cluster HJ with radial spreading anchoring traction technique is a useful surgical method for secure reconstruction of severely damaged hilar bile ducts.
Key words
Full text:
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Index:
WPRIM
Main subject:
Sutures
/
Traction
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Bile
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Bile Ducts
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Stents
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Drainage
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Connective Tissue
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Hepatic Duct, Common
Language:
En
Journal:
Korean Journal of Hepato-Biliary-Pancreatic Surgery
Year:
2016
Type:
Article