Reproducible Laparoscopic Hepaticojejunostomy Using a Double‐Armed Suture Technique Performed by a Procedure‐Naïve Surgeon

BACKGROUND: While minimally invasive pancreaticoduodenectomy (MIPD) has become increasingly common, biliary reconstruction remains a formidable technical hurdle. Ensuring the reproducibility of hepaticojejunostomy, particularly when performed by procedure-naïve surgeons, is a critical challenge. METHODS: We retrospectively analyzed consecutive patients who underwent MIPD with laparoscopic hepaticojejunostomy using a standardized technique employing a handmade double-armed suture. All procedures were performed by a procedure-naïve U40 surgeon under expert supervision. The anastomotic safety and reconstruction time were evaluated to assess reproducibility. RESULTS: A total of 23 patients were included. No bile leakage was observed, and anastomotic stricture occurred in 1 patient. The reconstruction time showed minimal variability throughout the series, indicating stable procedural performance from the early phase. CONCLUSION: A standardized laparoscopic hepaticojejunostomy technique can be safely and reproducibly performed by a procedure-naïve surgeon with sufficient foundational experience under structured supervision. Technique-based standardization may complement existing training strategies and facilitate sustainable dissemination of MIPD.