Economic and safety implications of continuous versus interrupted suturing method of hepaticojejunostomy: a prospective study

Galodha, Saurabh; Saxena, Rajan

doi:10.1016/j.hpb.2016.03.310

Cited by 3 publications

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“…The most common indication for performing HJ in modern era is malignant disease. Carcinoma head of the pancreas and periampullary carcinoma are the commonest pathology with the dilated and thick walled ducts 14 , 15 . There seems to be some form of bias in this study, as more malignant disease cases were undergoing continuous anastomosis.…”

Section: Discussionmentioning

confidence: 99%

Continuous versus interrupted anastomotic technique for the Hepaticojejunostomy-a prospective cohort study

Yadav,

Pandit,

Deo

et al. 2024

Annals of Medicine &Amp; Surgery

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Background: Interrupted sutures is the gold standard technique of Hepaticojejunostomy (HJ) for bilioenteric anastomosis. This study compares the safety and early complications of continuous and interrupted suture HJ. Methods: A prospective study involving all elective HJ between September 2019 and June 2021 was conducted. Patients with type IV or V biliary strictures, duct diameter <8 mm and/or associated vascular injury, and bilateral HJ were excluded. The study patients were divided into two random groups; interrupted and continuous anastomotic technique. Patient demographics, preoperative parameters including pathology (benign vs. malignant), HJ leak, suture time, and postoperative morbidity were recorded. Results: Total 34 patients were enrolled. Eighteen (52.9%) were into interrupted and 16 (47.1%) patients into the continuous group. Both the groups were comparable with regards to demographics, hemoglobin, serum albumin, preoperative cholangitis and biliary stenting. Total three (8.8%) patients in the entire study developed bile leak; interrupted-2 and continuous-1, which was not significant statistically (P=1.0). Similarly, total number of sutures used and the mean operating time to complete anastomosis in the continuous group was significantly lesser than the interrupted group (2.3±0.5 vs. 9.6±1.6, P<0.001) and (16.2±3.1 vs. 38.6±9.2 min, P<0.001) respectively. There were three (18.8%) re-exploration in the continuous anastomotic technique. Among them, only one re-operation was due to HJ anastomosis failure without mortality, remaining had re-exploration for bleeding (non-HJ). Conclusions: Both the techniques is safe with comparable morbidity. Further, continuous has an added advantage of decreased anastomotic time and cost.

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Section: Discussionmentioning

confidence: 99%

Continuous versus interrupted anastomotic technique for the Hepaticojejunostomy-a prospective cohort study

Yadav,

Pandit,

Deo

et al. 2024

Annals of Medicine &Amp; Surgery

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“…Studies comparing the safety and economic value of CSHJ and ISHJ groups are scarce. Galodha and Saxena [ 8 ] prospectively compared the cost of sutures (number and length) and operation room time associated with CSHJ and ISHJ in 40 patients under each group. The findings suggested that CSHJ was economical and safe ( Table 3 ).…”

Section: Discussionmentioning

confidence: 99%

Economics and safety of continuous and interrupted suture hepaticojejunostomy: An audit of 556 surgeries

Saxena

Ghosh

Galodha

2021

Ann Hepatobiliary Pancreat Surg

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Backgrounds/Aims: Hepaticojejunostomy (HJ) for bilioenteric continuity is generally performed with interrupted sutures. This study compares the safety, economics, short-and long-term outcomes of continuous suture hepaticojejunostomy (CSHJ) and interrupted suture hepaticojejunostomy (ISHJ). Methods: A retrospective cohort analysis involving all HJs between January 2014 and December 2018 was conducted. Patients with type IV or V biliary strictures, duct diameter < 8 mm and/or associated vascular injury, and liver transplant recipients were excluded. Patient demographics, preoperative parameters including diagnosis, intra-operative parameters including type and number of sutures, suture time, and postoperative morbidity (based on Clavien-Dindo classification) were recorded. Patients were followed up to 60 months. McDonald's Grade A and B outcomes were considered favorable. Cost according to suture type and number (polydioxanone 3-0/5-0 mean cost, US$ 9.26/length; polyglactin 3-0/4-0 mean cost, US$ 6.56/length), and operation room charge (US$ 67.47/hour) were compared between the two techniques. Statistical analysis was performed using IBM SPSS ver. 22 software. Results: A total of 556 eligible patients (468 patients undergoing ISHJ and 88 undergoing CSHJ; 47% [n = 261] with malignant and 53% [n = 295] with benign pathology) were analyzed. The two groups were similar. Number of sutures, cost, time, and postoperative bile leak were significantly higher in the ISHJ group. Bile leak occurred in 54 patients (6 CSHJ, 48 ISHJ). Septic shock-induced death occurred in 16 cases (3 CSHJ, 13 ISHJ). Morbidity and the anastomotic stricture rates were comparable in both groups. Conclusions: CSHJ is a safe, economical, and worthy of routine use.

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Meta-analysis of interrupted versus continuous suturing for Roux-en-Y hepaticojejunostomy and duct-to-duct choledochocholedochostomy

Hajibandeh

Parente

et al. 2022

Langenbecks Arch Surg

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Economic and safety implications of continuous versus interrupted suturing method of hepaticojejunostomy: a prospective study

Cited by 3 publications

References 0 publications

Continuous versus interrupted anastomotic technique for the Hepaticojejunostomy-a prospective cohort study

Continuous versus interrupted anastomotic technique for the Hepaticojejunostomy-a prospective cohort study

Economics and safety of continuous and interrupted suture hepaticojejunostomy: An audit of 556 surgeries

Meta-analysis of interrupted versus continuous suturing for Roux-en-Y hepaticojejunostomy and duct-to-duct choledochocholedochostomy

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