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Interrupted versus continuous suture technique for biliary-enteric anastomosis: randomized clinical trial
Lena Seifert1,2,3, Janusz von Renesse1, Adrian M Seifert1,2,3
1Department of Visceral, Thoracic and Vascular Surgery, University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany.
BJS Open
|February 1, 2023
Summary
Continuous sutures for biliary-enteric anastomosis (BEA) are faster than interrupted sutures. Both techniques demonstrate similar safety profiles and complication rates in patients undergoing BEA.
Area of Science:
- Surgical techniques
- Gastroenterology
- Anastomosis procedures
Background:
- Biliary-enteric anastomosis (BEA) is crucial in gastrointestinal surgery.
- Current evidence lacks high-quality data comparing continuous vs. interrupted suture techniques for BEA.
- This study addresses the need for comparative evidence on BEA suture methods.
Purpose of the Study:
- To compare continuous suture technique (CSG) with interrupted suture technique (ISG) for BEA.
- To evaluate suture time and short- and long-term biliary complications associated with each technique.
- To provide evidence-based guidance for optimizing BEA procedures.
Main Methods:
- Single-centre randomized clinical trial (NCT02658643) involving patients undergoing elective open BEA.
- Random allocation (1:1) to either continuous suture group (CSG) or interrupted suture group (ISG).
- Primary outcome: anastomosis completion time; Secondary outcomes: BEA-associated complications, morbidity, and mortality.
Main Results:
- 80 patients completed the study (39 ISG, 41 CSG).
- Suture time was significantly longer for ISG (median 22.4 min) compared to CSG (median 12.0 min) (P < 0.001).
- Biliary complications, including bile leakage, were similar between CSG and ISG; no anastomotic stenosis observed.
Conclusions:
- Continuous suture technique for BEA is faster than interrupted suture technique.
- Both techniques are equally safe, with comparable short- and long-term biliary complication rates.
- CSG offers a more time-efficient approach to BEA without compromising safety.
