Case Description
  • This video demonstrates the anastomotic technique of hepaticojejunostomy with three hepatic ducts.
  • Interrupted sutures are used both the anterior and posterior walls.
  • The entire row of duct posterior walls will be completed first, followed by the anterior row.
  • The sutures on the anterior walls of the hepatic ducts hold the anterior walls open to facilitate the posterior row suture placements.
  • A W-maneuver is performed on the 9 o’clock stay suture during placements of the posterior wall sutures.
  • Particular attention is paid to “string management” to organize the sutures and keep them from being entangled.
  • The posterior wall sutures are tied on the inside, while the stay sutures and the anterior wall sutures are tied on the outside.