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A modified method of hepaticocholedochojejunal anastomosis
Authors:D Atanasov  D Atanasova
Abstract:"Declive" latero-terminal and latero-lateral hepaticocholedocho-jejunoanastomosis with a loop of the small intestine isolated by the Roux method was carried out in 6 patients (5 females and 1 male) according to absolute indications. In this type of anastomosis, the longitudinal incision in the hepaticocholedochus is made not on the midline but latero-dorsally on its right supraduodenal circumference. The anastomosis is formed by means of a modified suture or a suture commonly used for bilio-digestive anastomoses; the needle is inserted through the wall of the bile duct 2-2.5 mm from the border of its opening and the sutures are placed at a similar distance from one another, the seromusculo-submucous sutures are applied 6-7 mm from the edge of the opening and at a distance of 3-3.5 mm from one another. Comparison with patients in whom heapticocholedochojejunoanastomosis was established by the routine method showed the results to be better in the modified method.
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