Yukawa Norio, Rino Yasushi, Yamanouchi Eigoro, Saeki Hiroyuki, Suganuma Nobuyasu, Iida Hiroshi, Kubota Kensuke, Nakajima Atsushi, Masuda Munetaka
Department of Surgery, Yokohama City University Hospital.
Nihon Shokakibyo Gakkai Zasshi. 2008 Oct;105(10):1523-8.
An 83-year-old man was admitted to our hospital with jaundice. At the age of 79, he had undergone distal gastrectomy with Roux-Y reconstruction and cholecystectomy due to early gastric cancer and gall bladder carcinoma. CT and MRI revealed severe dilatation from the common bile duct (CBD) to the intra-hepatic bile duct. Blood tests showed high serum levels of bilirubin and CA19-9. Cytology of the bile juice was Class V. Percutaneous transhepatic bile duct drainage was performed. Curative surgical resection was not indicated due to his age and general condition. Neither percutaneous nor endscopical fistulization were successful. Finally magnetic compression anastomosis was performed. Under general anesthesia, the first magnet was placed in the CBD through a cutaneous fistula. The second one was placed in the duodenum through the jejunum. The two magnets attached the walls of the CBD and duodenum. Three weeks after the maneuver, the anastomosis was completed with only a slight fever.
一名83岁男性因黄疸入住我院。79岁时，他因早期胃癌和胆囊癌接受了远端胃切除术加Roux-Y重建术及胆囊切除术。CT和MRI显示从胆总管（CBD）到肝内胆管严重扩张。血液检查显示血清胆红素和CA19-9水平升高。胆汁细胞学检查为V级。进行了经皮经肝胆管引流。由于他的年龄和一般状况，不适合进行根治性手术切除。经皮和内镜造瘘均未成功。最后进行了磁压缩吻合术。在全身麻醉下，通过皮肤瘘将第一块磁体放置在胆总管中。第二块磁体通过空肠放置在十二指肠中。两块磁体附着在胆总管和十二指肠壁上。操作三周后，吻合完成，仅伴有低热。
