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Erschienen in:

09.01.2021 | Original Article

Incidence of anastomotic stricture after hepaticojejunostomy with continuous sutures in patients who underwent laparoscopic pancreaticoduodenectomy

verfasst von: Yuichi Nagakawa, Shingo Kozono, Chie Takishita, Hiroaki Osakabe, Hitoe Nishino, Naoya Nakagawa, Kenta Suzuki, Yutaka Hayashi, Tetsuo Ishizaki, Kenji Katsumata, Akihiko Tsuchida

Erschienen in: Surgery Today | Ausgabe 7/2021

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Abstract

Purpose

Laparoscopic hepatojejunostomy (HJ) with continuous sutures is commonly performed in laparoscopic pancreaticoduodenectomy (LPD). This study aimed to investigate the long-term surgical outcomes of HJ in LPD.

Methods

We retrospectively evaluated 103 consecutive patients who underwent pancreaticoduodenectomy via laparoscopic HJ with continuous suturing using multifilament (n = 48) or monofilament-absorbable sutures (n = 47).

Results

During follow-up, anastomotic stricture of HJ was identified in 8 (7.8%) patients via balloon enteroscopy-assisted cholangiography. The median time from surgery to confirmation of stricture formation was 7.6 months (range 3.6–19.4). The incidence of HJ stricture was significantly higher in patients with a thin bile duct (diameter < 6.0 mm) than in those with a thick bile duct (diameter ≥ 6.0 mm) [7/27 (25.9%) vs. 1/76 (1.3%), respectively, p < 0.01]. Similarly, it was significantly higher in the monofilament group than in the multifilament group [7/54 (13.0%) vs. 1/49 (2.0%), respectively, p = 0.04]. In the monofilament suture group, 37.5% of patients with thin bile ducts developed stricture after HJ. A multivariate analysis revealed that a thin bile duct was an independent risk factor for HJ stricture (hazard ratio: 25.3, p < 0.01).

Conclusions

Stricture after laparoscopic HJ using continuous sutures frequently occurs in patients with thin bile ducts, particularly when monofilament-absorbable suture is used.
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Metadaten
Titel
Incidence of anastomotic stricture after hepaticojejunostomy with continuous sutures in patients who underwent laparoscopic pancreaticoduodenectomy
verfasst von
Yuichi Nagakawa
Shingo Kozono
Chie Takishita
Hiroaki Osakabe
Hitoe Nishino
Naoya Nakagawa
Kenta Suzuki
Yutaka Hayashi
Tetsuo Ishizaki
Kenji Katsumata
Akihiko Tsuchida
Publikationsdatum
09.01.2021
Verlag
Springer Singapore
Erschienen in
Surgery Today / Ausgabe 7/2021
Print ISSN: 0941-1291
Elektronische ISSN: 1436-2813
DOI
https://doi.org/10.1007/s00595-020-02223-z

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