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Continuous versus interrupted anastomotic technique for the hepaticojejunostomy: a prospective cohort study
Tek Narayan Yadav1, Narendra Pandit2, Kunal Bikram Deo1
1Department of Surgical, Gastroenterology B. P. Koirala Institute of Health Sciences, Dharan.
Annals of Medicine and Surgery (2012)
|April 5, 2024
Summary
Continuous suture hepaticojejunostomy (HJ) is a safe alternative to interrupted sutures, offering reduced operating time and cost. This comparison of HJ techniques found comparable safety and morbidity between the two methods.
Area of Science:
- Surgical innovation in hepatobiliary surgery.
- Comparative analysis of anastomotic techniques.
Background:
- Hepaticojejunostomy (HJ) is crucial for bilioenteric anastomosis.
- Interrupted sutures are the current gold standard for HJ.
- This study evaluates continuous versus interrupted suture techniques for HJ.
Purpose of the Study:
- To compare the safety and early complications of continuous and interrupted suture hepaticojejunostomy.
- To assess the feasibility and outcomes of a continuous suture technique for HJ.
Main Methods:
- Prospective study of elective HJ from September 2019 to June 2021.
- Exclusion criteria included complex biliary strictures and duct diameter < 8 mm.
- Patients randomized into interrupted (n=18) and continuous (n=16) suture groups.
Main Results:
- No statistically significant difference in bile leak rates (8.8%) between groups (P=1.0).
- Continuous HJ significantly reduced suture time (16.2 min vs 38.6 min, P<0.001) and suture count (2.3 vs 9.6, P<0.001).
- Re-exploration rates were similar, with one case of HJ anastomosis failure in the continuous group.
Conclusions:
- Both continuous and interrupted suture techniques for HJ are safe with comparable morbidity.
- Continuous suture HJ offers advantages of decreased anastomotic time and potentially lower costs.
- Continuous suture technique represents a viable alternative to interrupted sutures in HJ.
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