Nagaraj Kapil, Kalayarasan Raja, Gnanasekaran Senthil, Pottakkat Biju
Department of Surgical Gastroenterology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.
J Minim Access Surg. 2019 Apr-Jun;15(2):161-163. doi: 10.4103/jmas.JMAS_132_18.
Antro-pyloric stricture with gastric outlet obstruction is a common manifestation of corrosive-induced gastric injury. Surgical management is the only curative option as endoscopic dilatation usually fails in the long term. Billroth I gastrectomy with gastroduodenostomy is the preferred surgery as it restores normal alimentary pathway, reduces dumping and does not complicate colon mobilisation for the future oesophageal bypass. Conventionally, it is performed by the open approach. The present report is the first technical description of total laparoscopic Billroth-I gastrectomy using the laparoscopic linear cutter for corrosive-induced antropyloric stricture. The two patients who underwent this procedure had patent gastroduodenal anastomosis on the post-operative contrast study and tolerating normal diet at 9 and 6 months follow-up, respectively.
伴有胃出口梗阻的胃窦-幽门狭窄是腐蚀性胃损伤的常见表现。手术治疗是唯一的治愈选择，因为内镜扩张通常长期无效。毕罗一式胃切除术加胃十二指肠吻合术是首选手术，因为它可恢复正常的消化道通路，减少倾倒综合征，并且不会使未来食管旁路手术的结肠游离变得复杂。传统上，该手术通过开放手术进行。本报告是首次使用腹腔镜直线切割器对腐蚀性胃窦-幽门狭窄进行全腹腔镜毕罗一式胃切除术的技术描述。接受该手术的两名患者术后造影检查显示胃十二指肠吻合口通畅，分别在9个月和6个月的随访中能够耐受正常饮食。
