Novel sutureless cholangiojejunostomy: initial experience with 11 cases

Am J Surg. 2008 Feb;195(2):273-6. doi: 10.1016/j.amjsurg.2007.02.021.

Abstract

Background: It has become increasingly necessary to develop a reliable sutureless technique to replace the conventional hand-sewn one for carrying out bilioenteric anastomosis.

Methods: A new sutureless technique for cholangiojejunostomy is described, and a retrospective review was conducted of a prospectively collected database, which included 11 patients who underwent sutureless cholangiojejunostomy between April 2005 and July 2006.

Results: All patients successfully underwent sutureless cholangiojejunostomy, including choledochojejunostomy and hepaticojejunostomy. Median operative time was 13 minutes. There were no mortalities and no postoperative morbidities directly related to cholangiojejunostomy. At a mean follow-up period of 8.2 months, no patients had evidence of anastomotic stricture, except for 1 patient who developed obstructive jaundice because the recurrent tumor was pressing against the hepaticojejunal anastomosis.

Conclusions: Sutureless cholangiojejunostomy is simple, reliable, and feasible. Further larger-series studies, with longer follow-up periods and involving further improvements of the technique, are necessary before this procedure can become routine.

MeSH terms

  • Aged
  • Anastomosis, Surgical / adverse effects
  • Anastomosis, Surgical / methods
  • Bile Duct Neoplasms / pathology
  • Bile Duct Neoplasms / surgery
  • Bile Ducts, Intrahepatic / surgery*
  • Cholangiocarcinoma / pathology
  • Cholangiocarcinoma / surgery
  • Female
  • Follow-Up Studies
  • Humans
  • Jejunostomy / adverse effects
  • Jejunostomy / methods*
  • Male
  • Middle Aged
  • Pancreatic Neoplasms / pathology
  • Pancreatic Neoplasms / surgery
  • Pancreaticoduodenectomy / adverse effects
  • Pancreaticoduodenectomy / methods
  • Portoenterostomy, Hepatic / adverse effects
  • Portoenterostomy, Hepatic / methods*
  • Postoperative Complications / mortality
  • Prospective Studies
  • Risk Assessment
  • Survival Analysis
  • Sutures*
  • Treatment Outcome