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| Name | Standard bilioenteric anastomosis - 2. Exposing the CBD/CHD |
| Video Uploader | Video From webop Youtube |
| Upload Date | This Video Uploaded At 14-11-2019 13:59:39 |
| Video Discription | to see the complete lecture visit https://www.webop.com/general-and-visceral-surgery/Hepatobiliary-surgery/Standard-bilioenteric-anastomosis Principle: The gold standard in bilioenteric anastomosis is retrocolic end-to-side Roux-en-Y hepaticojejunostomy with a segment of the proximal jejunum. Here, the preferred bilioenteric anastomosis is established proximal to the cystic duct and about 2-3 cm distal to the union of the hepatic ducts. The opening of the anastomosis should be as wide as possible (if the common hepatic duct is too small it may be enlarged with the Hepp-Couinaud technique) The single row of interrupted suture encompassing all layers should be leak-roof from the beginning and precisely adapt the mucosa of the hepatic duct to that of the jejunum. 1. Exploration – exposure of the hepatoduodenal ligament (check playlist or webop.com for video) The anastomosis will be explained as part of the Whipple procedure for cancer of the pancreatic head. One modification of the bilioenteric anastomosis (hilar hepatojejunostomy) is found under Hepp-Couinaud technique for bilioenteric anastomosis. In the hepatoduodenal ligament expose the proper hepatic artery, portal vein and the CHD / CBD. Free the entire circumference of the duct. 2. Exposing the CBD/CHD Once the circumference of the duct has been freed completely, it is divided immediately proximal to the junction of the cystic duct. The duodenal end of the CBD is closed with an absorbable running suture (Vicryl® 3-0) (not shown). The part to be anastomosed is temporarily blocked with bulldog forceps. Note: Because of the clinically significant preoperative obstruction of the CBD, it had been decompressed before surgery by a blue drain through a stent. 3. Dissecting the jejunal loop (video + text on webop.com) ... to see further steps of the lecture with additional information or to learn everything about surgical operations visit https://www.webop.com |
| Category | Science & Technology |
| Tags | webop | surgery | medicine | bilioentericanastomosis |
