PDF(Pubmed)
Abstract：
BACKGROUND: The combination of magnetic compression anastomosis (MCA) and endoscopy has been used to treat biliary stricture after liver transplantation. However, its use for the treatment of complex biliary obstruction after major abdominal trauma has not been reported. This case report describes the successful use of MCA for the treatment of biliary obstruction resulting from major abdominal trauma.
METHODS: A 23-year-old man underwent major abdominal surgery (repair of liver rupture, right half colon resection, and ileostomy) following a car accident one year ago. The abdominal drainage tube, positioned at the Winslow foramen, was draining approximately 600-800 mL of bile per day. During the two endoscopic retrograde cholangiopancreatography procedures, the guide wire was unable to enter the common bile duct, which prevented placement of a biliary stent. MCA combined with endoscopy was used to successfully achieve magnetic anastomosis of the peritoneal sinus tract and duodenum, and then a choledochoduodenal stent was placed. Finally, the external biliary drainage tube was removed. The patient achieved internal biliary drainage leading to the removal of the external biliary drainage tube, which improved the quality of life.
CONCLUSIONS: Magnetic compression technique can be used for the treatment of complex biliary obstruction with minimal operative trauma.
METHODS: A 23-year-old man underwent major abdominal surgery (repair of liver rupture, right half colon resection, and ileostomy) following a car accident one year ago. The abdominal drainage tube, positioned at the Winslow foramen, was draining approximately 600-800 mL of bile per day. During the two endoscopic retrograde cholangiopancreatography procedures, the guide wire was unable to enter the common bile duct, which prevented placement of a biliary stent. MCA combined with endoscopy was used to successfully achieve magnetic anastomosis of the peritoneal sinus tract and duodenum, and then a choledochoduodenal stent was placed. Finally, the external biliary drainage tube was removed. The patient achieved internal biliary drainage leading to the removal of the external biliary drainage tube, which improved the quality of life.
CONCLUSIONS: Magnetic compression technique can be used for the treatment of complex biliary obstruction with minimal operative trauma.
摘要：
背景：磁性压缩吻合术（MCA）和内窥镜检查的组合已用于治疗肝移植后的胆管狭窄。然而,其用于严重腹部创伤后复杂胆道梗阻的治疗尚未见报道。此病例报告描述了MCA成功用于治疗因重大腹部创伤引起的胆道梗阻。
方法：一名23岁男子接受了腹部大手术（肝破裂修复，右半结肠切除术,和回肠造口术)一年前发生车祸后。腹部引流管,位于温斯洛孔处，每天排出约600-800毫升胆汁。在两次内镜逆行胰胆管造影术中，导丝无法进入胆总管,这阻止了胆道支架的放置。MCA联合内镜成功实现腹膜窦道与十二指肠的磁吻合,然后放置胆总管十二指肠支架。最后,拔除外部胆道引流管。患者实现了胆道内引流，从而拔除了胆道外引流管，提高了生活质量。
结论：磁压迫技术可用于复杂胆道梗阻的治疗，手术创伤小。
方法：一名23岁男子接受了腹部大手术（肝破裂修复，右半结肠切除术,和回肠造口术)一年前发生车祸后。腹部引流管,位于温斯洛孔处，每天排出约600-800毫升胆汁。在两次内镜逆行胰胆管造影术中，导丝无法进入胆总管,这阻止了胆道支架的放置。MCA联合内镜成功实现腹膜窦道与十二指肠的磁吻合,然后放置胆总管十二指肠支架。最后,拔除外部胆道引流管。患者实现了胆道内引流，从而拔除了胆道外引流管，提高了生活质量。
结论：磁压迫技术可用于复杂胆道梗阻的治疗，手术创伤小。
