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Figure 4 | World Journal of Surgical Oncology

Figure 4

From: Immunoglobulin G4-associated cholangitis mimicking cholangiocarcinoma treated by laparoscopic choledochectomy with intracorporeal Roux-en-Y hepaticojejunostomy

Figure 4

Intracorporeal side-to-side jejunojejunostomy. (A) Transection of the jejunum with an endoscopic linear stapler. (B) Approximation of left and right hepatic ducts and distal limb using a draft line. (C) A 5 mm wide incision at the antimesenteric side of the jejunum. (D) Long stay sutures to lift the corners at the 3 o’clock and 9 o’clock positions of the anastomotic stoma. (E,F) Suture of the posterior wall using interrupted sutures (G) Suture of the anterior wall using a continuous suture. (H) Strengthening of the seromuscular layer with interrupted sutures to reduce tension. LHD, left hepatic duct; RHD, right hepatic duct.

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