26vzmnrw014 10.3205/26vzmnrw014 urn:nbn:de:0183-26vzmnrw0140 Meeting Abstract Abdelsamad Abdelsamad A. A

Knappschaftskrankenhaus Recklinghausen (Klinikum Vest GmbH), Allgemein-, Viszeral- und robotische Chirurgie, Recklinghausen, Deutschland

author Herzog Herzog T. T

Ruhr-Universität Bochum, Knappschaft Klinikum Recklinghausen, Allgemein-, Viszeral- und robotische Chirurgie, Recklinghausen, Deutschland

author Gebauer Gebauer F. F

University of Witten/Herdecke, Witten, Deutschland Chirurgie II, Viszeralchirurgie- Universitätsklinikum Helios Wuppertal, Wuppertal, Deutschland

author German Medical Science GMS Publishing House

Düsseldorf

610 20260618 engl This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). M0644 014 Niederrheinisch-Westfälische Gesellschaft für Chirurgie Gesellschaft für Gastroenterologie in Nordrhein-Westfalen e.V. 192. Jahrestagung der Niederrheinisch-Westfälischen Gesellschaft für Chirurgie, 34. Jahrestagung der Gesellschaft für Gastroenterologie Viszeralmedizin NRW 2026 Interdisziplinär Dortmund 20260618 20260619 014 TextBackground and objective: 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.Method: 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–Ottawa 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.Result: Eight studies (1,190 patients) were included (continuous: 395, interrupted: 795). Continuous suturing significantly reduced anastomotic time (MD = -13.06 min, 95% CI: -17.37 to -8.75, P < 0.001) and costs (SMD = -4.89, 95% CI: -6.10 to -3.67, P < 0.001). However, no significant differences were observed in bile leakage, anastomotic stricture, morbidity, cholangitis, hospital stay, or re-exploration rates (P > 0.05). Sensitivity analyses confirmed these findings.Summary: Continuous suturing reduces anastomotic time by ~13 minutes and costs by ~$ 90 without increasing complications. However, given that HPB surgeries typically span several hours, this time reduction is clinically negligible. Interrupted suturing remains the most commonly used approach, and surgeons with proven success should not alter their technique based solely on these differences. Surgical choice should consider surgeon expertise, institutional protocols, and patient factors. Further randomized controlled trials are necessary to validate these findings. 0 0 0 0