Shimi S, Banting S, Cuschieri A
Department of Surgery, Ninewells Hospital and Medical School, University of Dundee, UK.
Br J Surg. 1992 Apr;79(4):317-9. doi: 10.1002/bjs.1800790411.
Following a period of animal experimentation in pigs, a laparoscopic technique for sutured gastrointestinal and bilioenteric anastomoses was developed and its safety and efficacy tested in chronic experiments. The method involves the construction of a preformed external jamming loop knot and continuous suturing using a specially developed Endoski needle. The technique was used to construct a cholecystojejunostomy in five patients with advanced cancer of the pancreas (four hand-sutured and one stapled/sutured). Four of the patients recovered from the procedure with no complications, minimal postoperative discomfort and complete relief of their jaundice. In one patient relief of jaundice was slow due to blockage of the anastomosis by debris and blood clot; this resolved following removal of the inspissated material. This minimally invasive procedure has the potential for complete palliation with short hospital stay and avoids the hazards of endoscopic stenting such as encrustation and cholangitis.
在对猪进行了一段时间的动物实验后，开发了一种用于缝合胃肠道和胆肠吻合术的腹腔镜技术，并在慢性实验中测试了其安全性和有效性。该方法包括构建一个预先形成的外部卡压环结，并使用专门开发的Endoski针进行连续缝合。该技术用于为5例晚期胰腺癌患者构建胆囊空肠吻合术（4例手工缝合，1例吻合器/缝合）。4例患者术后恢复良好，无并发症，术后不适轻微，黄疸完全消退。1例患者由于吻合口被碎片和血凝块堵塞，黄疸消退缓慢；清除浓缩物质后黄疸消退。这种微创手术有可能实现完全姑息治疗，住院时间短，并且避免了内镜支架置入术的风险，如结痂和胆管炎。
