{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T22:44:19Z","timestamp":1781909059080,"version":"3.54.5"},"reference-count":28,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2023,7,20]],"date-time":"2023-07-20T00:00:00Z","timestamp":1689811200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,7,20]],"date-time":"2023-07-20T00:00:00Z","timestamp":1689811200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["21K16447"],"award-info":[{"award-number":["21K16447"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100012330","name":"Okayama University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100012330","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Langenbecks Arch Surg"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Purpose<\/jats:title>\n                <jats:p>Biliary reconstruction remains a technically demanding and complicated procedure in minimally invasive hepatopancreatobiliary surgeries. No optimal hepaticojejunostomy (HJ) technique has been demonstrated to be superior for preventing biliary complications. This study aimed to investigate the feasibility of our unique technique of posterior double-layer interrupted sutures in robotic HJ.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>We performed a retrospective analysis of a prospectively collected database. Forty-two patients who underwent robotic pancreatoduodenectomy using this technique between September 2020 and November 2022 at our center were reviewed. In the posterior double-layer interrupted technique, sutures were placed to bite the bile duct, posterior seromuscular layer of the jejunum, and full thickness of the jejunum.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>The median operative time was 410 (interquartile range [IQR], 388\u2013478) min, and the median HJ time was 30 (IQR, 28\u201339) min. The median bile duct diameter was 7 (IQR, 6\u201310) mm. Of the 42 patients, one patient (2.4%) had grade B bile leakage. During the median follow-up of 12.6\u00a0months, one patient (2.4%) with bile leakage developed anastomotic stenosis. Perioperative mortality was not observed. A surgical video showing the posterior double-layer interrupted sutures in the robotic HJ is included.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Posterior double-layer interrupted sutures in robotic HJ provided a simple and feasible method for biliary reconstruction with a low risk of biliary complications.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00423-023-03020-1","type":"journal-article","created":{"date-parts":[[2023,7,19]],"date-time":"2023-07-19T23:02:03Z","timestamp":1689807723000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Innovative suture technique for robotic hepaticojejunostomy: double-layer interrupted sutures"],"prefix":"10.1007","volume":"408","author":[{"given":"Kosei","family":"Takagi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuzo","family":"Umeda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryuichi","family":"Yoshida","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomokazu","family":"Fuji","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuya","family":"Yasui","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takahito","family":"Yagi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshiyoshi","family":"Fujiwara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,7,20]]},"reference":[{"issue":"3","key":"3020_CR1","doi-asserted-by":"publisher","first-page":"329","DOI":"10.1016\/j.hpb.2019.09.016","volume":"22","author":"SK Kamarajah","year":"2020","unstructured":"Kamarajah SK et al (2020) A systematic review and network meta-analysis of different surgical approaches for pancreaticoduodenectomy. HPB (Oxford) 22(3):329\u2013339","journal-title":"HPB (Oxford)"},{"issue":"3","key":"3020_CR2","doi-asserted-by":"publisher","first-page":"909","DOI":"10.1007\/s13304-020-00916-1","volume":"73","author":"A Aiolfi","year":"2021","unstructured":"Aiolfi A et al (2021) Systematic review and updated network meta-analysis comparing open, laparoscopic, and robotic pancreaticoduodenectomy. Updates Surg 73(3):909\u2013922","journal-title":"Updates Surg"},{"issue":"1","key":"3020_CR3","doi-asserted-by":"publisher","first-page":"67","DOI":"10.1016\/j.hbpd.2018.10.005","volume":"18","author":"A El Nakeeb","year":"2019","unstructured":"El Nakeeb A et al (2019) Biliary leakage following pancreaticoduodenectomy: Prevalence, risk factors and management. Hepatobiliary Pancreat Dis Int 18(1):67\u201372","journal-title":"Hepatobiliary Pancreat Dis Int"},{"issue":"1","key":"3020_CR4","doi-asserted-by":"publisher","first-page":"80","DOI":"10.1089\/pancan.2021.0014","volume":"7","author":"W Farooqui","year":"2021","unstructured":"Farooqui W et al (2021) Biliary Leakage Following Pancreatoduodenectomy: Experience from a High-Volume Center. J Pancreat Cancer 7(1):80\u201385","journal-title":"J Pancreat Cancer"},{"issue":"10","key":"3020_CR5","doi-asserted-by":"publisher","first-page":"785","DOI":"10.1002\/jhbp.814","volume":"27","author":"G Honda","year":"2020","unstructured":"Honda G et al (2020) Basic knowledge of and a small trick for atraumatic needle driving in laparoscopic suturing. J Hepatobiliary Pancreat Sci 27(10):785\u2013788","journal-title":"J Hepatobiliary Pancreat Sci"},{"key":"3020_CR6","doi-asserted-by":"crossref","unstructured":"K\u00f6ckerling F (2014) Robotic vs Standard Laparoscopic Technique - What is Better? Front Surg 1: 15","DOI":"10.3389\/fsurg.2014.00015"},{"issue":"6","key":"3020_CR7","doi-asserted-by":"publisher","first-page":"4518","DOI":"10.1007\/s00464-021-08805-3","volume":"36","author":"MJW Zwart","year":"2022","unstructured":"Zwart MJW et al (2022) Performance with robotic surgery versus 3D- and 2D-laparoscopy during pancreatic and biliary anastomoses in a biotissue model: pooled analysis of two randomized trials. Surg Endosc 36(6):4518\u20134528","journal-title":"Surg Endosc"},{"issue":"1","key":"3020_CR8","doi-asserted-by":"publisher","first-page":"84","DOI":"10.1186\/s12893-018-0418-z","volume":"18","author":"M Brunner","year":"2018","unstructured":"Brunner M et al (2018) Continuous or interrupted suture technique for hepaticojejunostomy? A national survey. BMC Surg 18(1):84","journal-title":"BMC Surg"},{"issue":"10","key":"3020_CR9","doi-asserted-by":"publisher","first-page":"1442","DOI":"10.1016\/j.hpb.2020.02.007","volume":"22","author":"R Bustos","year":"2020","unstructured":"Bustos R et al (2020) Robotic hepaticojejunostomy: surgical technique and risk factor analysis for anastomotic leak and stenosis. HPB (Oxford) 22(10):1442\u20131449","journal-title":"HPB (Oxford)"},{"issue":"5","key":"3020_CR10","first-page":"363","volume":"70","author":"K Takagi","year":"2016","unstructured":"Takagi K et al (2016) Sarcopenia and American Society of Anesthesiologists Physical Status in the Assessment of Outcomes of Hepatocellular Carcinoma Patients Undergoing Hepatectomy. Acta Med Okayama 70(5):363\u2013370","journal-title":"Acta Med Okayama"},{"issue":"5","key":"3020_CR11","doi-asserted-by":"publisher","first-page":"680","DOI":"10.1016\/j.surg.2010.12.002","volume":"149","author":"M Koch","year":"2011","unstructured":"Koch M et al (2011) Bile leakage after hepatobiliary and pancreatic surgery: a definition and grading of severity by the International Study Group of Liver Surgery. Surgery 149(5):680\u2013688","journal-title":"Surgery"},{"issue":"3","key":"3020_CR12","doi-asserted-by":"publisher","first-page":"584","DOI":"10.1016\/j.surg.2016.11.014","volume":"161","author":"C Bassi","year":"2017","unstructured":"Bassi C et al (2017) The 2016 update of the International Study Group (ISGPS) definition and grading of postoperative pancreatic fistula: 11 Years After. Surgery 161(3):584\u2013591","journal-title":"Surgery"},{"issue":"5","key":"3020_CR13","doi-asserted-by":"publisher","first-page":"761","DOI":"10.1016\/j.surg.2007.05.005","volume":"142","author":"MN Wente","year":"2007","unstructured":"Wente MN et al (2007) Delayed gastric emptying (DGE) after pancreatic surgery: a suggested definition by the International Study Group of Pancreatic Surgery (ISGPS). Surgery 142(5):761\u2013768","journal-title":"Surgery"},{"issue":"1","key":"3020_CR14","doi-asserted-by":"publisher","first-page":"55","DOI":"10.1186\/s12957-021-02167-9","volume":"19","author":"K Takagi","year":"2021","unstructured":"Takagi K et al (2021) Surgical training model and safe implementation of robotic pancreatoduodenectomy in Japan: a technical note. World J Surg Oncol 19(1):55","journal-title":"World J Surg Oncol"},{"issue":"6","key":"3020_CR15","doi-asserted-by":"publisher","first-page":"e886","DOI":"10.1097\/SLA.0000000000004783","volume":"276","author":"MJW Zwart","year":"2022","unstructured":"Zwart MJW et al (2022) Outcomes of a Multicenter Training Program in Robotic Pancreatoduodenectomy (LAELAPS-3). Ann Surg 276(6):e886\u2013e895","journal-title":"Ann Surg"},{"issue":"23","key":"3020_CR16","doi-asserted-by":"publisher","first-page":"7112","DOI":"10.3390\/jcm11237112","volume":"11","author":"K Takagi","year":"2022","unstructured":"Takagi K et al (2022) Surgical Strategies to dissect around the superior mesenteric artery in robotic pancreatoduodenectomy. J Clin Med 11(23):7112","journal-title":"J Clin Med"},{"issue":"2","key":"3020_CR17","doi-asserted-by":"publisher","first-page":"732","DOI":"10.3390\/jcm12020732","volume":"12","author":"K Takagi","year":"2023","unstructured":"Takagi K et al (2023) Surgical Techniques of gastrojejunostomy in robotic pancreatoduodenectomy: robot-sewn versus stapled gastrojejunostomy anastomosis. J Clin Med 12(2):732","journal-title":"J Clin Med"},{"issue":"1","key":"3020_CR18","doi-asserted-by":"publisher","first-page":"6190","DOI":"10.1038\/s41598-023-33269-x","volume":"13","author":"YJ Chao","year":"2023","unstructured":"Chao YJ et al (2023) Feasibility of simultaneous development of laparoscopic and robotic pancreaticoduodenectomy. Sci Rep 13(1):6190","journal-title":"Sci Rep"},{"issue":"5","key":"3020_CR19","doi-asserted-by":"publisher","first-page":"389","DOI":"10.1001\/jamasurg.2020.0021","volume":"155","author":"Y Shi","year":"2020","unstructured":"Shi Y et al (2020) Short-term outcomes after robot-assisted vs open pancreaticoduodenectomy after the learning curve. JAMA Surg 155(5):389\u2013394","journal-title":"JAMA Surg"},{"issue":"9","key":"3020_CR20","doi-asserted-by":"publisher","first-page":"2927","DOI":"10.1007\/s00464-018-6595-0","volume":"33","author":"T Zhang","year":"2019","unstructured":"Zhang T et al (2019) The learning curve for a surgeon in robot-assisted laparoscopic pancreaticoduodenectomy: a retrospective study in a high-volume pancreatic center. Surg Endosc 33(9):2927\u20132933","journal-title":"Surg Endosc"},{"issue":"45","key":"3020_CR21","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000013000","volume":"97","author":"BU Shyr","year":"2018","unstructured":"Shyr BU et al (2018) Learning curves for robotic pancreatic surgery-from distal pancreatectomy to pancreaticoduodenectomy. Medicine (Baltimore) 97(45):e13000","journal-title":"Medicine (Baltimore)"},{"issue":"3","key":"3020_CR22","doi-asserted-by":"publisher","first-page":"185","DOI":"10.1016\/j.jviscsurg.2018.07.011","volume":"156","author":"F Guerra","year":"2019","unstructured":"Guerra F et al (2019) Surgical and oncological outcomes of our first 59 cases of robotic pancreaticoduodenectomy. J Visc Surg 156(3):185\u2013190","journal-title":"J Visc Surg"},{"issue":"2","key":"3020_CR23","doi-asserted-by":"publisher","first-page":"142","DOI":"10.1002\/jhbp.522","volume":"25","author":"HS Kim","year":"2018","unstructured":"Kim HS et al (2018) Comparison of surgical outcomes between open and robot-assisted minimally invasive pancreaticoduodenectomy. J Hepatobiliary Pancreat Sci 25(2):142\u2013149","journal-title":"J Hepatobiliary Pancreat Sci"},{"issue":"12","key":"3020_CR24","doi-asserted-by":"publisher","first-page":"3698","DOI":"10.1007\/s00464-015-4140-y","volume":"29","author":"S Chen","year":"2015","unstructured":"Chen S et al (2015) Robot-assisted laparoscopic versus open pancreaticoduodenectomy: a prospective, matched, mid-term follow-up study. Surg Endosc 29(12):3698\u20133711","journal-title":"Surg Endosc"},{"issue":"5","key":"3020_CR25","doi-asserted-by":"publisher","first-page":"555","DOI":"10.1007\/s11605-007-0166-3","volume":"11","author":"D Antolovic","year":"2007","unstructured":"Antolovic D et al (2007) Hepaticojejunostomy\u2013analysis of risk factors for postoperative bile leaks and surgical complications. J Gastrointest Surg 11(5):555\u2013561","journal-title":"J Gastrointest Surg"},{"issue":"10","key":"3020_CR26","doi-asserted-by":"publisher","first-page":"628","DOI":"10.1002\/jhbp.385","volume":"23","author":"T Asano","year":"2016","unstructured":"Asano T et al (2016) Incidence and risk factors for anastomotic stenosis of continuous hepaticojejunostomy after pancreaticoduodenectomy. J Hepatobiliary Pancreat Sci 23(10):628\u2013635","journal-title":"J Hepatobiliary Pancreat Sci"},{"issue":"7","key":"3020_CR27","doi-asserted-by":"publisher","first-page":"1212","DOI":"10.1007\/s00595-020-02223-z","volume":"51","author":"Y Nagakawa","year":"2021","unstructured":"Nagakawa Y et al (2021) Incidence of anastomotic stricture after hepaticojejunostomy with continuous sutures in patients who underwent laparoscopic pancreaticoduodenectomy. Surg Today 51(7):1212\u20131219","journal-title":"Surg Today"},{"issue":"11","key":"3020_CR28","doi-asserted-by":"publisher","first-page":"1744","DOI":"10.1016\/j.hpb.2021.04.010","volume":"23","author":"S Natsume","year":"2021","unstructured":"Natsume S et al (2021) Continuous suture is a risk factor for benign hepaticojejunostomy stenosis after pancreatoduodenectomy in patients with a non-dilated bile duct. HPB (Oxford) 23(11):1744\u20131750","journal-title":"HPB (Oxford)"}],"container-title":["Langenbeck's Archives of Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00423-023-03020-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00423-023-03020-1\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00423-023-03020-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,1,19]],"date-time":"2024-01-19T00:09:21Z","timestamp":1705622961000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00423-023-03020-1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,7,20]]},"references-count":28,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2023,12]]}},"alternative-id":["3020"],"URL":"https:\/\/doi.org\/10.1007\/s00423-023-03020-1","relation":{},"ISSN":["1435-2451"],"issn-type":[{"value":"1435-2451","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,7,20]]},"assertion":[{"value":"21 February 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"15 July 2023","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 July 2023","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"The authors declare no conflict of interest.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}],"article-number":"284"}}