{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T08:13:49Z","timestamp":1788250429327,"version":"build-2803163510"},"reference-count":55,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,7,4]],"date-time":"2025-07-04T00:00:00Z","timestamp":1751587200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,7,4]],"date-time":"2025-07-04T00:00:00Z","timestamp":1751587200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Private Universit\u00e4t Witten\/Herdecke gGmbH"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Langenbecks Arch Surg"],"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>Hepaticojejunostomy (HJ) is a crucial reconstructive step in upper gastrointestinal (UGI), pancreaticoduodenectomy (PD), and Hepaticobiliarypancreatic (HBP) surgeries. The optimal suturing technique remains debated, with conflicting evidence regarding operative efficiency, costs, and complications. This meta-analysis compares continuous and interrupted suturing to provide evidence-based recommendations.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>A systematic review and meta-analysis were conducted using PubMed, Embase, and Cochrane Library. Primary outcomes were anastomotic time and costs, while secondary outcomes included bile leakage, anastomotic stricture, morbidity, cholangitis, hospital stay, and re-exploration rates. A random or fixed-effects model was applied based on heterogeneity. We included randomized controlled trials and non-randomized cohort studies. The risk of bias was assessed using the Cochrane ROB 2 tool, Newcastle\u2013Ottawa Scale (NOS), and MINORS instrument as appropriate. Additionally, the quality of evidence for each outcome was evaluated using the GRADE approach. Sensitivity analyses were performed using the leave-one-out method.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Seven studies (1,159 patients) were included (continuous: 388, interrupted: 771). Continuous suturing significantly reduced anastomotic time (MD\u2009=\u2009-13.06\u00a0min, 95% CI: -17.37 to -8.75, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001) and costs (SMD\u2009=\u2009-4.89, 95% CI: -6.10 to -3.67, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). However, no significant differences were observed in bile leakage, anastomotic stricture, morbidity, cholangitis, hospital stay, or re-exploration rates (<jats:italic>P<\/jats:italic>\u2009&gt;\u20090.05). Sensitivity analyses confirmed these findings.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>Continuous suturing reduces anastomotic time by\u2009~\u200913\u00a0min and costs by\u2009~\u2009$90 without increasing complications. While these differences may be statistically significant, their clinical relevance can vary depending on the surgical context. Surgical choice should consider surgeon expertise, institutional protocols, and patient factors. Further randomized controlled trials are necessary to validate these findings.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s00423-025-03756-y","type":"journal-article","created":{"date-parts":[[2025,7,4]],"date-time":"2025-07-04T05:41:33Z","timestamp":1751607693000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Continuous vs. interrupted suturing in hepaticojejunostomy: a comprehensive systematic review and meta-analysis"],"prefix":"10.1007","volume":"410","author":[{"given":"Ahmed","family":"Abdelsamad","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammed Khaled","family":"Mohammed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ibrahim","family":"Khalil","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zeyad M.","family":"Wesh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omar A.","family":"Ahmed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed","family":"Elsherif","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jawad J. F.","family":"Alqedra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khaled Ashraf","family":"Mohamed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eslam","family":"Elmaghraby","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Torsten","family":"Herzog","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florian","family":"Gebauer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,7,4]]},"reference":[{"key":"3756_CR1","doi-asserted-by":"publisher","unstructured":"Jin J et al (2021) Robotic versus open pancreatoduodenectomy for pancreatic and periampullary tumors (PORTAL): a study protocol for a multicenter phase III non-inferiority randomized controlled trial. Trials 22(1). https:\/\/doi.org\/10.1186\/s13063-021-05939-6","DOI":"10.1186\/s13063-021-05939-6"},{"key":"3756_CR2","doi-asserted-by":"publisher","unstructured":"Di Carlo A, Gunder M, Doria C (2022) Surgical management of pancreatic adenocarcinoma. In: Hepato-Pancreato-Biliary Malig. Diagnosis Treat. 21st Century, pp 557\u2013568. https:\/\/doi.org\/10.1007\/978-3-030-41683-6_32","DOI":"10.1007\/978-3-030-41683-6_32"},{"key":"3756_CR3","doi-asserted-by":"publisher","unstructured":"Liu J et al (2024)Evaluation of the outcomes of biliary-enteric reconstruction in robotic radical resection of hilar cholangiocarcinoma: a single-center propensity score matching analysis. Sci Rep 14(1). https:\/\/doi.org\/10.1038\/s41598-024-65875-8","DOI":"10.1038\/s41598-024-65875-8"},{"issue":"3","key":"3756_CR4","doi-asserted-by":"publisher","first-page":"243","DOI":"10.1080\/17474124.2021.1847081","volume":"15","author":"J Wu","year":"2021","unstructured":"Wu J et al (2021) An essential technique for modern hepato-pancreato-biliary surgery: minimally invasive biliary reconstruction. Expert Rev Gastroenterol Hepatol 15(3):243\u2013254. https:\/\/doi.org\/10.1080\/17474124.2021.1847081","journal-title":"Expert Rev Gastroenterol Hepatol"},{"issue":"21","key":"3756_CR5","doi-asserted-by":"publisher","first-page":"696","DOI":"10.3238\/arztebl.m2024.0178","volume":"121","author":"M Brunner","year":"2024","unstructured":"Brunner M, Golcher H, Krautz C, Kersting S, Weber GF, Gr\u00fctzmann R (2024) Continuous or Interrupted Suture for Hepaticojejunostomy in Pancreaticoduodenectomy (The HEKTIK Trial). Dtsch Arztebl Int 121(21):696\u2013702. https:\/\/doi.org\/10.3238\/arztebl.m2024.0178","journal-title":"Dtsch Arztebl Int"},{"key":"3756_CR6","doi-asserted-by":"crossref","unstructured":"Hamdy MM, Ahmed et al (2024) Interrupted versus continuous sutures in the posterior wall of bilioenteric anastomosis: a retrospective study. Egypt J Surg 43(3):729\u2013741","DOI":"10.21608\/EJSUR.2024.357121"},{"key":"3756_CR7","doi-asserted-by":"publisher","unstructured":"Kuang Y, Ji R, Yuan T, Liu M (2024) Modified technique of Hepatojejunostomy for biliary tract reconstruction after resection of tumors affecting the perihilar region: a case series. BMC Surg 24(1). https:\/\/doi.org\/10.1186\/s12893-024-02393-4","DOI":"10.1186\/s12893-024-02393-4"},{"issue":"10","key":"3756_CR8","doi-asserted-by":"publisher","first-page":"1738","DOI":"10.1016\/j.hpb.2022.05.005","volume":"24","author":"N Napoli","year":"2022","unstructured":"Napoli N et al (2022) Outcomes of double-layer continuous suture hepaticojejunostomy in pancreatoduodenectomy and total pancreatectomy. HPB 24(10):1738\u20131747. https:\/\/doi.org\/10.1016\/j.hpb.2022.05.005","journal-title":"HPB"},{"issue":"8","key":"3756_CR9","doi-asserted-by":"publisher","first-page":"959","DOI":"10.1007\/s00423-018-1733-7","volume":"403","author":"T Tatsuguchi","year":"2018","unstructured":"Tatsuguchi T et al (2018) Short- and long-term outcomes of choledochojejunostomy during pancreaticoduodenectomy and total pancreatectomy: interrupted suture versus continuous suture. Langenbeck\u2019s Arch Surg 403(8):959\u2013966. https:\/\/doi.org\/10.1007\/s00423-018-1733-7","journal-title":"Langenbeck\u2019s Arch Surg"},{"key":"3756_CR10","doi-asserted-by":"publisher","unstructured":"Brunner M et al (2018) Continuous or interrupted suture technique for hepaticojejunostomy? A national survey. BMC Surg 18(1). https:\/\/doi.org\/10.1186\/s12893-018-0418-z","DOI":"10.1186\/s12893-018-0418-z"},{"key":"3756_CR11","doi-asserted-by":"publisher","first-page":"S322","DOI":"10.14701\/ahbps.EP-124","volume":"25","author":"R Saxena","year":"2021","unstructured":"Saxena R, Ghosh NK, Galodha S (2021) Continuous suture hepaticojejunostomy is economical with similar long term results as interrupted suture technique: An audit of a prospective database of 556 hepaticojejunostomies. Ann Hepato-Biliary-Pancreatic Surg 25:S322. https:\/\/doi.org\/10.14701\/ahbps.EP-124","journal-title":"Ann Hepato-Biliary-Pancreatic Surg"},{"issue":"11","key":"3756_CR12","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 23(11):1744\u20131750. https:\/\/doi.org\/10.1016\/j.hpb.2021.04.010","journal-title":"HPB"},{"key":"3756_CR13","doi-asserted-by":"publisher","unstructured":"Seifert L et al (2023) Interrupted versus continuous suture technique for biliary-enteric anastomosis: randomized clinical trial. BJS Open 7(1). https:\/\/doi.org\/10.1093\/bjsopen\/zrac163","DOI":"10.1093\/bjsopen\/zrac163"},{"issue":"1","key":"3756_CR14","doi-asserted-by":"publisher","first-page":"131","DOI":"10.4103\/ejs.ejs_267_23","volume":"43","author":"TA Sabra","year":"2024","unstructured":"Sabra TA et al (2024) Outcomes of continous versus interrupted suturing techniques for biliary-enteric anastomosis after choledochal cyst excision in children. Egypt J Surg 43(1):131\u2013138. https:\/\/doi.org\/10.4103\/ejs.ejs_267_23","journal-title":"Egypt J Surg"},{"issue":"4","key":"3756_CR15","doi-asserted-by":"publisher","first-page":"1950","DOI":"10.1097\/ms9.0000000000001902","volume":"86","author":"TN Yadav","year":"2024","unstructured":"Yadav TN, Pandit N, Deo KB, Awale L, Neupane D, Adhikary S (2024) Continuous versus interrupted anastomotic technique for the hepaticojejunostomy: a prospective cohort study. Ann Med Surg 86(4):1950\u20131955. https:\/\/doi.org\/10.1097\/ms9.0000000000001902","journal-title":"Ann Med Surg"},{"issue":"4","key":"3756_CR16","doi-asserted-by":"publisher","first-page":"150","DOI":"10.18528\/ijgii220041","volume":"11","author":"EJ Houghton","year":"2022","unstructured":"Houghton EJ, Rubio JS (2022) Surgical management of the postoperative complications of hepato-pancreato-biliary surgery. Int J Gastrointest Interv 11(4):150\u2013155. https:\/\/doi.org\/10.18528\/ijgii220041","journal-title":"Int J Gastrointest Interv"},{"issue":"4","key":"3756_CR17","doi-asserted-by":"publisher","first-page":"461","DOI":"10.1016\/j.jamcollsurg.2020.12.062","volume":"232","author":"A Rosemurgy","year":"2021","unstructured":"Rosemurgy A et al (2021) Cost analysis of Pancreaticoduodenectomy at a high-volume robotic Hepatopancreaticobiliary surgery program. J Am Coll Surg 232(4):461\u2013469. https:\/\/doi.org\/10.1016\/j.jamcollsurg.2020.12.062","journal-title":"J Am Coll Surg"},{"issue":"1","key":"3756_CR18","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1002\/jhbp.515","volume":"25","author":"M Yokoe","year":"2018","unstructured":"Yokoe M et al (2018) Tokyo guidelines 2018: diagnostic criteria and severity grading of acute cholecystitis (with videos). J Hepatobiliary Pancreat Sci 25(1):41\u201354. https:\/\/doi.org\/10.1002\/jhbp.515","journal-title":"J Hepatobiliary Pancreat Sci"},{"issue":"14","key":"3756_CR19","doi-asserted-by":"publisher","first-page":"142","DOI":"10.56645\/jmde.v6i14.284","volume":"6","author":"M Tarsilla","year":"2010","unstructured":"Tarsilla M (2010) Cochrane handbook for systematic reviews of interventions. J Multidiscip Eval 6(14):142\u2013148. https:\/\/doi.org\/10.56645\/jmde.v6i14.284","journal-title":"J Multidiscip Eval"},{"issue":"4","key":"3756_CR20","doi-asserted-by":"publisher","first-page":"314","DOI":"10.1080\/08941939.2017.1420837","volume":"32","author":"P T\u00e9oule","year":"2019","unstructured":"T\u00e9oule P, Bartel F, Birgin E, R\u00fcckert F, Wilhelm TJ (2019) The Clavien-Dindo classification in pancreatic surgery: a clinical and economic validation. J Investig Surg 32(4):314\u2013320. https:\/\/doi.org\/10.1080\/08941939.2017.1420837","journal-title":"J Investig Surg"},{"key":"3756_CR21","doi-asserted-by":"publisher","DOI":"10.1136\/bmj-2023-076754","author":"MJ Page","year":"2023","unstructured":"Page MJ et al (2023) ROB-ME: a tool for assessing risk of bias due to missing evidence in systematic reviews with meta-analysis. BMJ. https:\/\/doi.org\/10.1136\/bmj-2023-076754","journal-title":"BMJ"},{"key":"3756_CR22","doi-asserted-by":"publisher","unstructured":"Sterne JAC et al (2019) RoB 2: A revised tool for assessing risk of bias in randomised trials. BMJ 366. https:\/\/doi.org\/10.1136\/bmj.l4898","DOI":"10.1136\/bmj.l4898"},{"key":"3756_CR23","unstructured":"Ottawa Hospital Research Institute. [cited 2024 May 18].\u2019, [Internet], [Online]. Available: https:\/\/www.ohri.ca\/programs\/clinical_epidemiology\/oxford.asp. Accessed 11.02.2025"},{"issue":"2","key":"3756_CR24","doi-asserted-by":"publisher","first-page":"173","DOI":"10.1016\/j.jclinepi.2012.08.001","volume":"66","author":"GH Guyatt","year":"2013","unstructured":"Guyatt GH et al (2013) GRADE guidelines: 13. preparing summary of findings tables and evidence profiles - Continuous outcomes. J Clin Epidemiol 66(2):173\u2013183. https:\/\/doi.org\/10.1016\/j.jclinepi.2012.08.001","journal-title":"J Clin Epidemiol"},{"issue":"3","key":"3756_CR25","doi-asserted-by":"publisher","first-page":"177","DOI":"10.1016\/0197-2456(86)90046-2","volume":"7","author":"R DerSimonian","year":"1986","unstructured":"DerSimonian R, Laird N (1986) Meta-analysis in clinical trials. Control Clin Trials 7(3):177\u2013188","journal-title":"Control Clin Trials"},{"issue":"3","key":"3756_CR26","doi-asserted-by":"publisher","first-page":"1","DOI":"10.18637\/jss.v036.i03","volume":"36","author":"W Viechtbauer","year":"2010","unstructured":"Viechtbauer W (2010) Conducting meta-analyses in R with the metafor. J Stat Softw 36(3):1\u201348","journal-title":"J Stat Softw"},{"issue":"4","key":"3756_CR27","doi-asserted-by":"publisher","first-page":"719","DOI":"10.1093\/jnci\/22.4.719","volume":"22","author":"N Mantel","year":"1959","unstructured":"Mantel N, Haenszel W (1959) Statistical aspects of the analysis of data from retrospective studies of disease. J Natl Cancer Inst 22(4):719\u2013748. https:\/\/doi.org\/10.1093\/jnci\/22.4.719","journal-title":"J Natl Cancer Inst"},{"issue":"9","key":"3756_CR28","doi-asserted-by":"publisher","first-page":"1351","DOI":"10.1002\/sim.1761","volume":"23","author":"MJ Sweeting","year":"2004","unstructured":"Sweeting MJ, Sutton AJ, Lambert PC (2004) What to add to nothing? Use and avoidance of continuity corrections in meta-analysis of sparse data. Stat Med 23(9):1351\u20131375. https:\/\/doi.org\/10.1002\/sim.1761","journal-title":"Stat Med"},{"issue":"7414","key":"3756_CR29","doi-asserted-by":"publisher","first-page":"557","DOI":"10.1136\/bmj.327.7414.557","volume":"327","author":"JPT Higgins","year":"2003","unstructured":"Higgins JPT, Thompson SG, Deeks JJ, Altman DG (2003) Measuring inconsistency in meta-analyses. Br Med J 327(7414):557\u2013560. https:\/\/doi.org\/10.1136\/bmj.327.7414.557","journal-title":"Br Med J"},{"issue":"2","key":"3756_CR30","doi-asserted-by":"publisher","first-page":"112","DOI":"10.1002\/jrsm.11","volume":"1","author":"W Viechtbauer","year":"2010","unstructured":"Viechtbauer W, Cheung MWL (2010) Outlier and influence diagnostics for meta-analysis. Res Synth Methods 1(2):112\u2013125. https:\/\/doi.org\/10.1002\/jrsm.11","journal-title":"Res Synth Methods"},{"issue":"4","key":"3756_CR31","doi-asserted-by":"publisher","first-page":"153","DOI":"10.1136\/ebmental-2019-300117","volume":"22","author":"S Balduzzi","year":"2019","unstructured":"Balduzzi S, R\u00fccker G, Schwarzer G (2019) How to perform a meta-analysis with R: a practical tutorial. Evid Based Ment Health 22(4):153\u2013160. https:\/\/doi.org\/10.1136\/ebmental-2019-300117","journal-title":"Evid Based Ment Health"},{"key":"3756_CR32","unstructured":"Gordon M, Lumley T (2022) \u2018_forestplot: Advanced Forest Plot Using \u201cgrid\u201d Graphics_. R package version 3.1.1.\u2019. [Online]. Version 3.1.7. Available: https:\/\/cran.r-project.org\/web\/\/packages\/\/forestplot\/forestplot.pdf.\u00a0Accessed 12.06.2025"},{"key":"3756_CR33","doi-asserted-by":"publisher","unstructured":"Bramis J, Gomatos IP, Konstandoulakis MM (2006) Operations of the biliary tract. technical aspects. Liver Biliary Tract Surg Embryol Anat to 3D-Imaging Transpl Innov 297\u2013313. https:\/\/doi.org\/10.1007\/978-3-211-49277-2_24","DOI":"10.1007\/978-3-211-49277-2_24"},{"key":"3756_CR34","doi-asserted-by":"publisher","unstructured":"Marichez A, Adam JP, Laurent C, Chiche L (2023) Hepaticojejunostomy for bile duct injury: state of the art. Langenbeck\u2019s Arch Surg 408(1). https:\/\/doi.org\/10.1007\/s00423-023-02818-3","DOI":"10.1007\/s00423-023-02818-3"},{"key":"3756_CR35","doi-asserted-by":"publisher","unstructured":"Kron P, Lodge JPA (2023) Principles and techniques of liver resection. Liver Gall Bl Bile Ducts 223:223-C21P85. https:\/\/doi.org\/10.1093\/med\/9780192862457.003.0021","DOI":"10.1093\/med\/9780192862457.003.0021"},{"key":"3756_CR36","unstructured":"Williamsson C (2017) Perioperative aspects of pancreaticoduodenectomy. [Online]. Available: https:\/\/lucris.lub.lu.se\/ws\/portalfiles\/portal\/24198203\/Caroline_W_webb_paperI_IV.pdf. Accessed 12.02.2025"},{"issue":"5","key":"3756_CR37","doi-asserted-by":"publisher","first-page":"910","DOI":"10.1097\/SLA.0b013e318158a403","volume":"246","author":"CM Vollmer","year":"2007","unstructured":"Vollmer CM, Pratt W, Callery MP (2007) Clinical and economic validation of the international study group of pancreatic fistula classification scheme [8]. Ann Surg 246(5):910. https:\/\/doi.org\/10.1097\/SLA.0b013e318158a403","journal-title":"Ann Surg"},{"issue":"1","key":"3756_CR38","doi-asserted-by":"publisher","first-page":"24","DOI":"10.26758\/7.1.3","volume":"7","author":"A Ferdohleb","year":"2017","unstructured":"Ferdohleb A (2017) Evaluation of the surgical management and remote outcomes in patients with postoperative biliary strictures in the Republic of Moldova. Anthropol Res Stud 7(1):24\u201335. https:\/\/doi.org\/10.26758\/7.1.3","journal-title":"Anthropol Res Stud"},{"key":"3756_CR39","doi-asserted-by":"publisher","unstructured":"Mariani A, Tripepi M, Mangoni I, Aseni P (2023) Major complications in hepatobiliary and pancreatic surgery. High-Risk Surg Patient pp 475\u2013490. https:\/\/doi.org\/10.1007\/978-3-031-17273-1_44","DOI":"10.1007\/978-3-031-17273-1_44"},{"key":"3756_CR40","doi-asserted-by":"publisher","unstructured":"Long W, Vemulapalli P, Sockell A, Gilchrist B (2024) Biliary Tract trauma. Biliary Tract - Dis Treat Qual Life [Working Title]. https:\/\/doi.org\/10.5772\/intechopen.1006535","DOI":"10.5772\/intechopen.1006535"},{"key":"3756_CR41","doi-asserted-by":"publisher","unstructured":"Biagiola DA, Glinka J, S\u00e1nchez Claria R (2022) Biliodigestive anastomosis. Fundam Bile Duct Inj.From Prev Multidiscip Manag pp 127\u2013137. https:\/\/doi.org\/10.1007\/978-3-031-13383-1_15","DOI":"10.1007\/978-3-031-13383-1_15"},{"issue":"4","key":"3756_CR42","doi-asserted-by":"publisher","first-page":"487","DOI":"10.1097\/00000658-200110000-00008","volume":"234","author":"KC Conlon","year":"2001","unstructured":"Conlon KC et al (2001) Prospective randomized clinical trial of the value of intraperitoneal drainage after pancreatic resection. Ann Surg 234(4):487\u2013494. https:\/\/doi.org\/10.1097\/00000658-200110000-00008","journal-title":"Ann Surg"},{"issue":"4","key":"3756_CR43","doi-asserted-by":"publisher","first-page":"426","DOI":"10.1097\/00000658-199404000-00014","volume":"219","author":"P Neuhaus","year":"1994","unstructured":"Neuhaus P, Blumhardt G, Bechstein WO, Steffen R, Platz KP, Keck H (1994) Technique and results of biliary reconstruction using side-to-side choledochocholedochostomy in 300 orthotopic liver transplants. Ann Surg 219(4):426\u2013434. https:\/\/doi.org\/10.1097\/00000658-199404000-00014","journal-title":"Ann Surg"},{"issue":"4","key":"3756_CR44","doi-asserted-by":"publisher","first-page":"546","DOI":"10.1111\/j.1399-0012.2009.00994.x","volume":"23","author":"WG Polak","year":"2009","unstructured":"Polak WG, Peeters PMJG, Slooff MJH (2009) The evolution of surgical techniques in clinical liver transplantation. A review. Clin Transplant 23(4):546\u2013564. https:\/\/doi.org\/10.1111\/j.1399-0012.2009.00994.x","journal-title":"Clin Transplant"},{"key":"3756_CR45","doi-asserted-by":"publisher","unstructured":"Dostal J, Klein P, Blassova T, Priban V (2024) Impact of suturing techniques on microvascular anastomosis maturation. J Neurol Surg Part A Cent Eur Neurosurg. https:\/\/doi.org\/10.1055\/a-2389-7761","DOI":"10.1055\/a-2389-7761"},{"issue":"3","key":"3756_CR46","doi-asserted-by":"publisher","first-page":"530","DOI":"10.1053\/jhsu.2001.22933","volume":"26","author":"YX Chen","year":"2001","unstructured":"Chen YX, Chen LE, Seaber AV, Urbaniak JR (2001) Comparison of continuous and interrupted suture techniques in microvascular anastomosis. J Hand Surg Am 26(3):530\u2013539. https:\/\/doi.org\/10.1053\/jhsu.2001.22933","journal-title":"J Hand Surg Am"},{"key":"3756_CR47","doi-asserted-by":"publisher","unstructured":"Berci G (2018) Historical perspective on the treatment of choledocholithiasis: Lessons learned and techniques prior to the laparoscopic era. Choledocholithiasis Compr Surg Manag pp 3\u201328. https:\/\/doi.org\/10.1007\/978-3-319-74503-9_1","DOI":"10.1007\/978-3-319-74503-9_1"},{"issue":"6","key":"3756_CR48","doi-asserted-by":"publisher","first-page":"2036","DOI":"10.1016\/0016-5085(86)90292-1","volume":"90","author":"B Sigel","year":"1986","unstructured":"Sigel B (1986) Common bile duct exploration (intraoperative investigations in biliary tract surgery). Gastroenterology 90(6):2036. https:\/\/doi.org\/10.1016\/0016-5085(86)90292-1","journal-title":"Gastroenterology"},{"issue":"4","key":"3756_CR49","doi-asserted-by":"publisher","first-page":"578","DOI":"10.1016\/j.amjsurg.2013.01.044","volume":"206","author":"T Herzog","year":"2013","unstructured":"Herzog T et al (2013) The difficult hepaticojejunostomy after pancreatic head resection: reconstruction with a T tube. Am J Surg 206(4):578\u2013585. https:\/\/doi.org\/10.1016\/j.amjsurg.2013.01.044","journal-title":"Am J Surg"},{"issue":"12","key":"3756_CR50","doi-asserted-by":"publisher","first-page":"1421","DOI":"10.1016\/j.dld.2020.07.026","volume":"52","author":"P Cant\u00f9","year":"2020","unstructured":"Cant\u00f9 P, Mauro A, Cassinotti E, Boni L, Vecchi M, Penagini R (2020) Post-operative biliary strictures. Dig Liver Dis 52(12):1421\u20131427. https:\/\/doi.org\/10.1016\/j.dld.2020.07.026","journal-title":"Dig Liver Dis"},{"key":"3756_CR51","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-024-11222-x","author":"A Abdelsamad","year":"2024","unstructured":"Abdelsamad A et al (2024) Robotic-assisted versus laparoscopic-assisted extended mesorectal excision: a comprehensive meta-analysis and systematic review of perioperative and long-term outcomes. Surg Endosc. https:\/\/doi.org\/10.1007\/s00464-024-11222-x","journal-title":"Surg Endosc"},{"issue":"4","key":"3756_CR52","doi-asserted-by":"publisher","first-page":"1179","DOI":"10.1016\/j.surg.2024.06.027","volume":"176","author":"Z Li","year":"2024","unstructured":"Li Z et al (2024) Early mobilization after pancreatic surgery: a randomized controlled trial. Surg (United States) 176(4):1179\u20131188. https:\/\/doi.org\/10.1016\/j.surg.2024.06.027","journal-title":"Surg (United States)"},{"key":"3756_CR53","doi-asserted-by":"publisher","first-page":"686","DOI":"10.1111\/j.1432-2277.1994.tb01479.x","volume":"7","author":"C Chardot","year":"1994","unstructured":"Chardot C (1994) Biliary complications after paediatric liver transplantation: role of the biliary tube. Transpl Int 7:686\u2013686. https:\/\/doi.org\/10.1111\/j.1432-2277.1994.tb01479.x","journal-title":"Transpl Int"},{"issue":"5","key":"3756_CR54","doi-asserted-by":"publisher","first-page":"1797","DOI":"10.1007\/s00423-022-02522-8","volume":"407","author":"A Abdelsamad","year":"2022","unstructured":"Abdelsamad A et al (2022) Active aspiration versus simple compression to remove residual gas from the abdominal cavity after laparoscopic cholecystectomy: a randomized clinical trial. Langenbeck\u2019s Arc of surg 407(5):1797\u20131804. https:\/\/doi.org\/10.1007\/s00423-022-02522-8","journal-title":"Langenbeck\u2019s Arc of surg"},{"key":"3756_CR55","doi-asserted-by":"publisher","unstructured":"Abdelsamad A et al (2024) Worse cholecystectomy outcomes during the COVID-19 pandemic: were staff shortages or a change in patient case-mix the culprit?\u00a0Surg Endosc 38(12):7389\u20137398. https:\/\/doi.org\/10.1007\/s00464-024-11337-1","DOI":"10.1007\/s00464-024-11337-1"}],"container-title":["Langenbeck's Archives of Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00423-025-03756-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00423-025-03756-y\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00423-025-03756-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,4]],"date-time":"2025-07-04T05:41:36Z","timestamp":1751607696000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00423-025-03756-y"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,4]]},"references-count":55,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["3756"],"URL":"https:\/\/doi.org\/10.1007\/s00423-025-03756-y","relation":{},"ISSN":["1435-2451"],"issn-type":[{"value":"1435-2451","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,4]]},"assertion":[{"value":"18 February 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 May 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"4 July 2025","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 interest"}}],"article-number":"214"}}