An improved laparoscopic choledochojejunostomy technique (with video)

Area of Science:

• Hepatobiliary surgery
• Minimally invasive surgery
• Surgical anastomosis

Background:

• Choledochojejunostomy is crucial in hepatobiliary pancreatic surgery for procedures like pancreaticoduodenectomy and liver transplantation.
• Laparoscopic guidance is vital for patient recovery, but instrument limitations pose challenges.
• Standardized methods are lacking, particularly for delicate bile ducts.

Purpose of the Study:

• To present a modified laparoscopic choledochojejunostomy technique.
• To address the difficulties associated with laparoscopic anastomosis, especially in challenging cases.
• To summarize technical aspects and experiences from high-volume centers.

Main Methods:

• Modification of traditional laparoscopic choledochojejunostomy.
• Integration of continuous sutures for posterior and anterior walls.
• Supplementation with intermittent knot-tying for the anterior wall.

Main Results:

• The modified technique simplifies the choledochojejunostomy procedure.
• It reduces the technical difficulty of laparoscopic anastomosis.
• An experienced surgeon can safely perform this programmed anastomosis.

Conclusions:

• The modified anastomotic technique offers satisfactory results.
• It simplifies the procedure and enhances safety in laparoscopic surgery.
• Further large-scale studies are needed to confirm reduced complications and improved outcomes.