Extramucosal hepaticojejunostomy

ackground The creation of a secure hepaticojejunostomy is an essential skill for any hepatobiliary surgeon. Methods We describe a refined technique of sewing the end of the common hepatic duct to the side of the jejunum. The sutures are placed to include all layers of the bowel wall except mucosa. Results One hundred eighty-five anastomoses were performed over a 6-year period. There were 3 documented leaks, 1 significant anastomotic bleed, and 2 postoperative strictures. There were no deaths. Conclusion This refined technique facilitates accurate placement of sutures by improving vision and results in a well-vascularized watertight connection.