Digestive Endoscopy Unit, Ospedale Civile di Villa d'Agri, ASP Potenza, Via Provinciale, Marsicovetere, 85050, Villa d'Agri (Potenza), Italy,
Updates Surg. 2013 Sep;65(3):231-5. doi: 10.1007/s13304-012-0139-2. Epub 2012 Mar 6.
We report the successful removal of an intraduodenal foreign body (f.b.) by endo-laparoscopic rendezvous, in a 67-year-old patient with mental disorders and duodenal occlusion by a large peach seed impacted in the duodenum. During a first endoscopic diagnostic evaluation it was possible to retract the peach seed into the stomach and have a confirmation of a stenosis of the second portion of the duodenum. Otherwise, the endoscopic procedure failed during removal out of the esophagus due to the large size of the f.b., and a second treatment in general anesthesia was planned. A 4 cm anterior gastrotomy was than performed by laparoscopy, and with a real endo-laparoscopic rendezvous, the peach seed out of the stomach was positioned, avoiding any intra-gastric surgical manouver and directly passing from Dormia basket into laparoscopic plastic retrieval bag. The gastrotomy was than closed with a single cartridge of a linear stapler and reinforced with an oversewn suture.
我们报告了一例通过内镜腹腔镜会师术成功取出十二指肠内异物（f.b.）的病例，该患者为 67 岁精神障碍患者，因一颗大桃仁嵌顿于十二指肠而导致十二指肠梗阻。在首次内镜诊断评估中，我们成功地将桃仁拉入胃内，并确认了十二指肠第二段狭窄。然而，由于异物较大，在将其从食管中取出的过程中内镜手术失败，因此计划进行第二次全身麻醉下的治疗。然后通过腹腔镜进行了 4 厘米的前胃切开术，通过真正的内镜腹腔镜会师术，将桃仁从胃中定位，避免了任何胃内手术操作，并直接从 Dormia 篮中进入腹腔镜塑料回收袋。然后用一个线性吻合器的单个钉匣关闭胃切开术，并通过缝合加固。
