Matsuura Rei, Ueno Takehisa, Tazuke Yuko, Tanaka Natsumi, Yamanaka Hiroaki, Takama Yuichi, Nakahata Kengo, Yamamichi Taku, Maeda Noboru, Osuga Keigo, Yamanouchi Eigoro, Okuyama Hiroomi
Department of Pediatric Surgery, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan.
Department of Diagnostic and Interventional Radiology, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan.
Pediatr Int. 2017 Jun;59(6):737-739. doi: 10.1111/ped.13295.
We report a case of successful magnetic compression anastomosis (MCA) for obstructed cyst-jejunostomy in a young woman who had undergone surgery for type 1 biliary atresia (BA) on day 78 of life. A 16-year-old girl was admitted with obstructive jaundice. Jaundice resolved with percutaneous trans-hepatic cholangiodrainage (PTCD) but contrast medium injected from the PTCD tube did not flow through the anastomosis. Magnets were placed on each side of the anastomosis, in the cyst and the jejunum, to compress the partition. On postoperative day (POD) 6, the anastomosis was recanalized and the PTCD tube placed trans-anastomotically until POD 245. The patient remained free from jaundice after removal of the PTCD tube. MCA can be a useful and less invasive procedure for treating biliary tract anastomotic obstruction in patients with BA.
我们报告了一例成功应用磁性压缩吻合术(MCA)治疗一名年轻女性阻塞性囊肿空肠吻合口狭窄的病例,该女性在出生后第78天接受了1型胆道闭锁(BA)手术。一名16岁女孩因阻塞性黄疸入院。经皮经肝胆道引流(PTCD)使黄疸消退,但从PTCD管注入的造影剂未通过吻合口。在囊肿和空肠的吻合口两侧放置磁铁以压缩分隔物。术后第6天,吻合口再通,PTCD管经吻合口放置直至术后第245天。拔除PTCD管后,患者黄疸消退。MCA对于治疗BA患者的胆道吻合口梗阻可能是一种有用且侵入性较小的手术方法。