[Biliodigestive anastomosis: technique and outcome].

The biliodigestive anastomosis represents a core element of hepatopancreatobiliary surgery. It requires a precise surgical technique and detailed knowledge of biliary anatomy and vascular supply. A tension-free suture, sufficient perfusion of the anastomosed structures and an exact mucosa-to-mucosa adaptation using delicate absorbable suture material are decisive for a successful construction. Hepaticojejunostomy has become established as the gold standard for a biliodigestive anastomosis. Currently available studies show no significant differences in morbidity between open and minimally invasive techniques, whereby the latter is becoming increasingly more important. There was also no difference in the clinical results with respect to the suture technique (interrupted vs. continuous suture); however, the continuous suture technique is associated with a shortening of the placement time and a reduction in costs. Complications after biliodigestive anastomosis, such as insufficiency and stenosis, are clinically relevant and substantially influence the morbidity and mortality; however, many of these complications can nowadays be effectively treated by interventional procedures.