Video Experimental Relacionado
Updated: Feb 20, 2026
Modified Laparoscopic Anatomic Hepatectomy: Two-Surgeon Technique Combined with the Simple Extracorporeal Pringle Maneuver
Published on: June 16, 2023
Hepatico-yeyunostomía Laparoscópica Reproducible Utilizando una Técnica de Sutura de Doble Aguja Realizada por un
Mampei Kawashima1, Yoshiharu Nakamura1, Akira Matsushita2
1Department of Gastrointestinal Surgery, Nippon Medical School Chiba Hokuso Hospital, Chiba, Japan.
Background:
While minimally invasive pancreaticoduodenectomy (MIPD) has become increasingly common, biliary reconstruction remains a formidable technical hurdle. Ensuring the reproducibility of hepaticojejunostomy, particularly when performed by procedure-naïve surgeons, is a critical challenge.
Methods:
We retrospectively analyzed consecutive patients who underwent MIPD with laparoscopic hepaticojejunostomy using a standardized technique employing a handmade double-armed suture. All procedures were performed by a procedure-naïve U40 surgeon under expert supervision. The anastomotic safety and reconstruction time were evaluated to assess reproducibility.
Results:
A total of 23 patients were included. No bile leakage was observed, and anastomotic stricture occurred in 1 patient. The reconstruction time showed minimal variability throughout the series, indicating stable procedural performance from the early phase.
Conclusion:
A standardized laparoscopic hepaticojejunostomy technique can be safely and reproducibly performed by a procedure-naïve surgeon with sufficient foundational experience under structured supervision. Technique-based standardization may complement existing training strategies and facilitate sustainable dissemination of MIPD.
