{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T19:02:51Z","timestamp":1777921371967,"version":"3.51.4"},"reference-count":14,"publisher":"SAGE Publications","issue":"10","license":[{"start":{"date-parts":[[2019,10,1]],"date-time":"2019-10-01T00:00:00Z","timestamp":1569888000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Laparoendoscopic &amp; Advanced Surgical Techniques"],"published-print":{"date-parts":[[2019,10,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim:<\/jats:title>\n                    <jats:p>In children, the diameter at the hepaticojejunostomy anastomosis (HJA) can range from 10\u2009mm to less than 5\u2009mm, irrespective of the type of choledochal cyst (CC). We developed a maneuver that involves everting the mucosa (EM) of the Roux-en-Y loop jejunum and the common hepatic duct mucosa circumferentially, to facilitate suturing during laparoscopic HJA (lap-HJA). Otherwise, it is extremely difficult to distinguish between the lumen and the mucosa on the jejunal side.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We used EM to treat 18 consecutive children with CC between 2016 and 2018. After transumbilical, extracorporeal Roux-en-Y loop-plasty, the closed end of the jejunum was incised with a scalpel and bleeding points were coagulated with bipolar diathermy. During lap-HJA, the mucosa at the incision was everted circumferentially by using 7\/0 absorbable sutures and anastomosed securely to the common hepatic duct by using 5\/0 or 6\/0 absorbable sutures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Mean age at surgery was 4.0 years old. HJA diameters were &lt;5\u2009mm (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u20094), 5\u20139\u2009mm (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u200911), and &gt;9\u2009mm (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u20093). In all cases, EM allowed the lumen at the incision in the Roux-en-Y loop jejunum to be distinguished readily, and suturing proceeded smoothly. After follow-up of a mean of 1.5 years (range 0.5\u20133.0), no anastomotic leakages or stenoses have been reported.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>EM greatly facilitated secure anastomosis during lap-HJA, even when the diameter at the anastomosis was &lt;5\u2009mm. The safety and efficiency of lap-HJA in children with CC could be improved by this simple maneuver.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/lap.2019.0192","type":"journal-article","created":{"date-parts":[[2019,9,18]],"date-time":"2019-09-18T11:29:21Z","timestamp":1568806161000},"page":"1345-1348","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":11,"title":["Everting the Jejunal Mucosa Ensures a Secure Hepaticojejunostomy Anastomosis During Laparoscopic Repair of Choledochal Cyst in Children"],"prefix":"10.1177","volume":"29","author":[{"given":"Hiroyuki","family":"Koga","sequence":"first","affiliation":[{"name":"Department of Pediatric General and Urogenital Surgery, Juntendo University School of Medicine, Tokyo, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takanori","family":"Ochi","sequence":"additional","affiliation":[{"name":"Department of Pediatric General and Urogenital Surgery, Juntendo University School of Medicine, Tokyo, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroshi","family":"Murakami","sequence":"additional","affiliation":[{"name":"Department of Pediatric General and Urogenital Surgery, Juntendo University School of Medicine, Tokyo, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Go","family":"Miyano","sequence":"additional","affiliation":[{"name":"Department of Pediatric General and Urogenital Surgery, Juntendo University School of Medicine, Tokyo, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Geoffrey J.","family":"Lane","sequence":"additional","affiliation":[{"name":"Department of Pediatric General and Urogenital Surgery, Juntendo University School of Medicine, Tokyo, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Atsuyuki","family":"Yamataka","sequence":"additional","affiliation":[{"name":"Department of Pediatric General and Urogenital Surgery, Juntendo University School of Medicine, Tokyo, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2019,10,14]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-010-1435-x"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00383-009-2343-9"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-010-1183-y"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2011.09.056"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1002\/jhbp.346"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00383-015-3781-1"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.7196\/SAMJ.8921"},{"key":"e_1_3_3_9_2","first-page":"354","article-title":"Congenital choledochal cyst: Video-guided laparoscopic treatment","volume":"5","author":"Farello GA","year":"1995","unstructured":"Farello GA, , Cerofolini A, , Rebonato M, , Bergamaschi G, , Ferrari C, , Chiappetta A. Congenital choledochal cyst: Video-guided laparoscopic treatment. Surg Laparosc Endosc, 1995; 5:354\u2013358.","journal-title":"Surg Laparosc Endosc"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF00309000"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00383-014-3501-2"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00383-007-1929-3"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF00174590"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-0029-1202365"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2017.03.036"}],"container-title":["Journal of Laparoendoscopic &amp; Advanced Surgical Techniques"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1089\/lap.2019.0192","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/lap.2019.0192","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/lap.2019.0192","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T19:52:47Z","timestamp":1777665167000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1089\/lap.2019.0192"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,10,1]]},"references-count":14,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2019,10,1]]}},"alternative-id":["10.1089\/lap.2019.0192"],"URL":"https:\/\/doi.org\/10.1089\/lap.2019.0192","relation":{},"ISSN":["1092-6429","1557-9034"],"issn-type":[{"value":"1092-6429","type":"print"},{"value":"1557-9034","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,10,1]]}}}