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Hepaticojejunostomy in Minimally Invasive Surgery: A Step-by-Step Guide
Younsoo Seoorcid, Inhyuck Leeorcid, Go-Won Choiorcid, Yoon Soo Chaeorcid, Won-Gun Yunorcid, Young Jae Choorcid, Hye-Sol Jungorcid, Joon Seong Parkorcid, Jin-Young Jangorcid, Wooil Kwonorcid
Journal of Surgical Innovation and Education 2024;1(2):53-54.
DOI: https://doi.org/10.69474/jsie.2024.00192
Published online: December 12, 2024

Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea

Corresponding author: Wooil Kwon, MD, PhD Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea Tel: +82-2-2072-2817, Fax: +82-2-766-3975, E-mail: 'willdoc78@gmail.com'
• Received: November 8, 2024   • Accepted: November 25, 2024

© 2024 Korean Surgical Skill Study Group

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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  • With rapid advances in minimally invasive surgery (MIS) techniques, such as laparoscopy and robotics, their application has expanded across various surgical fields, including pancreatobiliary surgery. Numerous studies have demonstrated the feasibility and potential benefits of MIS. Hepaticojejunostomy, a procedure creating a connection between the hepatic duct and the jejunum, is primarily used to bypass biliary obstructions or during operations that involve bile duct resection, such as pancreatoduodenectomy or choledochal cyst excision. Proficiency in minimally invasive hepaticojejunostomy techniques is essential for surgeons in this evolving field. This video presents a detailed, step-by-step guide to the principles and techniques of performing hepaticojejunostomy using both laparoscopic and robotic platforms.
00:00:01 Introduction
00:00:10 History of bilioenteric anastomosis
00:00:35 Definition and indication of hepaticojejunostomy
00:01:03 Principles of anastomosis
00:01:17 Three steps in hepaticojejunostomy
00:01:35 Port placement
00:01:54 Laparoscopic hepaticojejunostomy
00:02:02 Stage 1: jejunal preparation
00:02:11 Stay suturing
00:02:37 Jejunal transection
00:03:01 Mesenteric opening formation
00:03:32 Stage 2: anastomosis
00:03:34 Jejunal incision formation
00:03:44 Stay suturing
00:04:11 Posterior wall interrupted suturing
00:05:11 Anterior wall interrupted suturing
00:06:01 Stage 3: limb anchoring
00:06:04 Interrupted suture of jejunum and mesenteric opening
00:06:20 Application of fibrin glue
00:06:29 Advantages of robotic surgery
00:06:51 Robotic hepaticojejunostomy (interrupted method)
00:07:00 Posterior wall interrupted suturing
00:07:34 Silastic tube indwelling
00:07:49 Anterior wall interrupted suturing
00:08:22 Robotic hepaticojejunostomy (continuous method)
00:08:36 Posterior wall continuous suturing
00:09:35 Silastic tube indwelling
00:09:48 Anterior wall interrupted suturing
  • 1. Moris D, Papalampros A, Vailas M, Petrou A, Kontos M, Felekouras E. The hepaticojejunostomy technique with intra-anastomotic stent in biliary diseases and its evolution throughout the years: a technical analysis. Gastroenterol Res Pract. 2016;2016:3692096.ArticlePubMedPMCPDF
  • 2. Sahoo MR, Ali MS, Sarthak S, Nayak J. Laparoscopic hepaticojejunostomy for benign biliary stricture: a case series of 16 patients at a tertiary care centre in India. J Minim Access Surg. 2022;18:20-24.ArticlePubMedPMC
  • 3. Ahrendt SA, Pitt HA. A history of the bilioenteric anastomosis. Arch Surg. 1990;125:1493-1500.ArticlePubMed
  • 4. Supe AN, Kulkarni GV, Supe PA. Ergonomics in laparoscopic surgery. J Minim Access Surg. 2010;6:31-36.ArticlePubMedPMC

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        Hepaticojejunostomy in Minimally Invasive Surgery: A Step-by-Step Guide
        J Surg Innov Educ. 2024;1(2):53-54.   Published online December 12, 2024
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