A 2-cm, 360 degree wrap is created using three interrupted, nonabsorbable sutures with care to avoid the anterior vagus.
A. Three to six interrupted 0-gauge silk sutures are used to close the crura. B. Exposure of the crura and posterior aspect of the esophagus is facilitated by traction on a Penrose drain encircling the gastroesophageal junction.
A. The folded T-tube is inserted into the choledochotomy. B. Ttube in place. The choledochotomy will be closed from above downward. The T-tube will exit from the lower end of the choledochotomy when the sutures are placed.