Annals of Hepato-Biliary-Pancreatic Surgery

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Fig. 5.

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Fig. 5. Intraoperative photograph showing the procedure of end-to-end choledochojejunostomy with segmental resection of the common bile duct (CBD) in Case No. 2. (A) The dilated CBD is visible after cholecystectomy. (B) The mid-portion of the CBD is incised longitudinally, showing multiple CBD stones and sludges. (C) The distal CBD is dissected and transected at the narrow portion of the intrapancreatic bile duct, and then securely closed with 5-0 Prolene sutures. (D) The proximal CBD was also transected at the level of the right hepatic artery to make a large proximal bile duct opening. (E, F) A Roux-en-Y jejunal limb is anastomosed to the CBD opening in an end-to-side fashion.
Ann Hepatobiliary Pancreat Surg 2021;25:259-64
© 2021 Ann Hepatobiliary Pancreat Surg