Department of Surgery, University of Minnesota, 420 Delaware Street, MMC 290, Minneapolis, MN 55455, USA.
World J Surg. 2011 Feb;35(2):372-6. doi: 10.1007/s00268-010-0873-x.
Revision surgery to eliminate a gastrogastric fistula (GGF) is often associated with high morbidity.
This report describes a percutaneous transgastric approach for revision surgery in three patients with GGF using a transgastric, totally extraperitoneal approach.
The access was performed successfully in all the patients. There were no intraoperative complications, and the patients had an uneventful recovery. One patient had a recurrence 8 months after the procedure but had achieved satisfactory weight loss during the period. We were able to perform a second percutaneous transgastric repair. The second patient showed an asymptomatic recurrence of the fistula, which was later completely repaired. The third patient has had moderate weight loss.
Although current results are not optimal, we believe that this approach could represent an alternative for patients with a hostile abdomen or in whom co-morbidities comprise a prohibitive factor. Further experience, technical improvements, and longer follow-up are needed to evaluate and optimize this approach and evaluate its potential use in other surgical areas.
消除胃胃瘘（Gastrogastric Fistula，GGF）的翻修手术通常与高发病率相关。
本报告描述了使用经胃、完全腹膜外入路，对 3 名 GGF 患者进行经皮经胃翻修手术的方法。
所有患者均成功进行了入路操作。术中无并发症，患者恢复顺利。1 例患者在术后 8 个月复发，但在此期间体重减轻令人满意。我们能够进行第二次经皮经胃修复。第二例患者出现无症状瘘复发，后来完全修复。第三位患者体重减轻适中。
尽管目前的结果并不理想，但我们认为，对于腹部情况不佳或合并症构成禁忌因素的患者，这种方法可能是一种替代选择。需要进一步的经验、技术改进和更长时间的随访，以评估和优化这种方法，并评估其在其他手术领域的潜在用途。
