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胃旁路术后胃食管连接部漏并发严重脓毒症:内镜辅助腔内食管引流和自膨式覆膜金属支架治疗成功。

Gastroesophageal junction leak with serious sepsis after gastric bypass: successful treatment with endoscopy-assisted intraluminal esophageal drainage and self-expandable covered metal stent.

机构信息

Department of General Surgery, Hospital Universitario de Canarias, 38320 La Laguna, S/C de Tenerife, Canary Islands, Spain.

出版信息

Obes Surg. 2010 Feb;20(2):240-3. doi: 10.1007/s11695-009-9978-4. Epub 2009 Sep 26.

Abstract

We present a case of gastroesophageal junction leak after gastric bypass with serious sepsis and hemodynamic instability. Minimally invasive treatment was performed in two stages: initial sepsis control by lavage and endoscopy-assisted laparoscopic placement of an intraluminal esophageal drainage tube through the leak orifice; this was followed by definitive leak treatment with a self-expandable covered metal stent after achieving hemodynamic stability. Patient evolution was satisfactory without the need for open surgery.

摘要

我们报告了一例胃旁路术后胃食管连接部漏的病例,该患者合并严重脓毒症和血流动力学不稳定。微创治疗分两阶段进行:首先通过灌洗控制初始脓毒症,然后在内镜辅助下通过漏口放置腔内食管引流管进行腹腔镜辅助置管;在血流动力学稳定后,使用自膨式覆膜金属支架进行确定性漏处理。患者的病情演变良好,无需开腹手术。

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