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磁压榨吻合术治疗良性胆道狭窄。

Magnetic compression anastomosis for treatment of benign biliary stricture.

机构信息

Department of Internal Medicine, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea.

出版信息

Dig Endosc. 2015 Jan;27(2):239-49. doi: 10.1111/den.12319. Epub 2014 Oct 16.

Abstract

Endoscopic and percutaneous procedures have shown high success rates when used to treat benign biliary stricture. However, cases in which a guidewire cannot be passed through a refractory stricture or a complete obstruction are difficult to treat using conventional methods. Magnetic compression anastomosis (MCA) has emerged as a non-surgical alternative avoiding operational mortality and morbidity. The feasibility and safety of MCA have been experimentally and clinically verified in cases of biliobiliary and bilioenteric anastomosis. However, no pre-MCA assessment modality capable of predicting outcomes is as yet available, and no universally effective magnet delivery method has as yet been established, rendering it difficult to identify patients for whom MCA is appropriate. Various experimental studies seeking to overcome these limitations are underway. Such work will improve our in-depth understanding of MCA, which has been trialed in various fields. Upon further development, MCA may become a ground-breaking option for treatment of benign strictures that are difficult to resolve using conventional methods, and MCA may be expected to be minimally traumatic and highly effective. The aim of the present study was to discuss the current status of MCA and the direction of MCA development by reviewing clinical and experimental MCA data.

摘要

内镜和经皮介入治疗技术在治疗良性胆道狭窄方面显示出了较高的成功率。然而,对于那些导丝无法通过难治性狭窄或完全梗阻的病例,传统方法治疗起来较为困难。磁压迫吻合术(Magnetic Compression Anastomosis,MCA)作为一种非手术方法,避免了手术相关的死亡率和发病率,已逐渐应用于临床。MCA 在胆肠吻合和胆胰吻合方面的可行性和安全性已在实验和临床研究中得到验证。然而,目前尚无能够预测治疗效果的预 MCA 评估方法,也没有建立起通用的、有效的磁铁输送方法,这使得难以确定哪些患者适合接受 MCA 治疗。目前正在进行各种旨在克服这些局限性的实验研究。这些研究将有助于我们深入了解 MCA,目前 MCA 已在多个领域得到了试验。进一步发展后,MCA 可能成为治疗传统方法难以解决的良性狭窄的突破性选择,并且 MCA 可能具有创伤小、效果好的特点。本研究旨在通过回顾 MCA 的临床和实验数据,讨论 MCA 的现状和发展方向。

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