腹腔镜辅助经胃会师术治疗既往接受过Roux-en-Y胃旁路术患者的胆总管结石
Laparoscopy-Assisted Trans-Gastric Rendez-vous for the Treatment of Common Bile Duct Stones in Patients with Prior Roux-en-Y Gastric Bypass.
作者信息
Mejía Ricardo, Achurra Pablo, Gabrielli Mauricio, Briceño Eduardo, Rebolledo Rolando, Torres Alberto, Sharp Allan, Pimentel Fernando, Crovari Fernando
机构信息
Department of Gastrointestinal Surgery, Pontificia Universidad Católica de Chile, Marcoleta 367, Santiago, Chile.
出版信息
Obes Surg. 2016 Nov;26(11):2809-2813. doi: 10.1007/s11695-016-2360-4.
BACKGROUND
Common bile duct (CBD) stones in a Roux-en-Y gastric bypass (RYGB) represent a major challenge for ERCP due to long-limb anatomy. Trans-gastric approach has been proposed but entails high ERCP-related risks. Laparoscopy assisted trans-gastric rendez-vous (LATG-RV) is a one-step procedure that may lower the risks of these patients.
METHODS
We describe our initial experience in four patients with past history of RYGB and CBD stones.
RESULTS
All patients underwent LATG-RV and had successful CBD stone clearance. Postoperative course was uneventful with normal amylase levels. Average procedure time was 105 min and postoperative stay 2 days.
CONCLUSION
LATG-RV is a safe and effective procedure for the clearance of CBD stones in RYGB patients. It may have fewer complications and shorter operative time than regular trans-gastric ERCP.
背景
由于Roux-en-Y胃旁路术（RYGB）的长襻解剖结构，胆总管（CBD）结石对内镜逆行胰胆管造影术（ERCP）而言是一项重大挑战。经胃途径已被提出，但会带来较高的ERCP相关风险。腹腔镜辅助经胃会师术（LATG-RV）是一种一步式手术，可能会降低这些患者的风险。
方法
我们描述了4例有RYGB和CBD结石病史患者的初步经验。
结果
所有患者均接受了LATG-RV手术，且成功清除了CBD结石。术后过程平稳，淀粉酶水平正常。平均手术时间为105分钟，术后住院时间为2天。
结论
LATG-RV是一种安全有效的清除RYGB患者CBD结石的手术。与常规经胃ERCP相比，它可能并发症更少，手术时间更短。
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