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腹腔镜胃部分分隔式胃空肠吻合术是一种有效的姑息性手术,可改善恶性胃十二指肠梗阻患者的生活质量。

Laparoscopic stomach-partitioning gastrojejunostomy is an effective palliative procedure to improve quality of life in patients with malignant gastroduodenal outlet obstruction.

作者信息

Eguchi Hidetoshi, Yada Kazuhiro, Shibata Kohei, Matsumoto Toshifumi, Etoh Tsuyoshi, Yasuda Kazuhiro, Inomata Masafumi, Shiraishi Norio, Ohta Masayuki, Kitano Seigo

机构信息

Department of Surgery I, Oita University Faculty of Medicine, Oita, Japan.

出版信息

Asian J Endosc Surg. 2012 Nov;5(4):153-6. doi: 10.1111/j.1758-5910.2012.00151.x. Epub 2012 Sep 20.

Abstract

INTRODUCTION

A patient with gastroduodenal obstruction caused by an unresectable gastroduodenal or periampullary cancer cannot ingest food and/or liquid. The patient's quality of life rapidly deteriorates, resulting in a dismal prognosis. Stomach-partitioning gastrojejunostomy has been previously reported, and here, we evaluate the laparoscopic procedure.

METHODS

We performed laparoscopic stomach-partitioning gastrojejunostomy in 18 patients with unresectable gastroduodenal or periampullary cancers. Data on operation time, blood loss, complications, and postoperative course were retrospectively collected.

RESULTS

The mean operation time was 152 min, and conversion to open surgery was not required in any patients. Postoperative complications occurred in three patients (17%) and included cholangitis, anastomotic ulcer hemorrhage, and enterocolitis. The mean time to oral intake was 4.5 days, and the mean and median duration of oral intake were maintained for 133 and 88 days, respectively.

CONCLUSION

Laparoscopic stomach-partitioning gastrojejunostomy is a safe and effective procedure that allows patients with gastroduodenal outlet obstruction to eat again and improve the quality of their remaining life.

摘要

引言

由不可切除的胃十二指肠或壶腹周围癌引起胃十二指肠梗阻的患者无法摄入食物和/或液体。患者的生活质量迅速恶化,导致预后不佳。此前已有胃分隔式胃空肠吻合术的报道,在此,我们对该腹腔镜手术进行评估。

方法

我们对18例不可切除的胃十二指肠或壶腹周围癌患者实施了腹腔镜胃分隔式胃空肠吻合术。回顾性收集手术时间、失血量、并发症及术后病程的数据。

结果

平均手术时间为152分钟,所有患者均无需转为开腹手术。3例患者(17%)出现术后并发症,包括胆管炎、吻合口溃疡出血和小肠结肠炎。开始经口进食的平均时间为4.5天,经口进食的平均时长和中位时长分别维持了133天和88天。

结论

腹腔镜胃分隔式胃空肠吻合术是一种安全有效的手术,能使胃十二指肠出口梗阻的患者再次进食,并改善其剩余生命的质量。

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