Department of Hepatobiliary Surgery and Institute of Advanced Surgical Technology and Engineering, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
Shaanxi Provincial Regenerative Medicine and Surgical Engineering Research Center, Xi'an, China.
J Gastroenterol Hepatol. 2019 Mar;34(3):589-594. doi: 10.1111/jgh.14500. Epub 2018 Oct 19.
Magnetic anastomosis has been attempted in biliary and intestinal reconstruction. The objective of the current study was to introduce an initial clinical use of magnetic compression anastomosis for pancreaticojejunostomy and biliojejunostomy in Whipple's procedure.
Patients with peri-ampullary carcinoma and dilated bile and pancreatic ducts were prospectively enrolled from 2016 to 2017. After pancreaticoduodenectomy, an appropriate mother magnet and drainage tube was placed in the proximal bile duct and pancreatic duct. The daughter magnets were introduced to mate with the mother magnets at the anastomotic sites. A close postoperative surveillance and routine cholangiopancreaticography via the drainage tube were performed.
One female and three male patients with a median age of 69 years (range, 57-77) were included. The diameter of the common bile ducts and pancreatic ducts ranged from 8 to 15 mm, and 7 to 10 mm, respectively. The median time duration for biliojejunostomy and pancreaticojejunostomy was 7 (range, 5-8 min) min and 9 (range, 8-10 min) min, respectively. The median time of biliojejunostomy and pancreaticojejunostomy formation was 17 (range, 15-21 days) days and 11 (range, 10-18 days), respectively. With a median follow up of 313 days, one patient developed biliary anastomotic stricture at 11 months after surgery, and underwent stent placement via percutaneous transhepatic drainage sinus, and recovered well.
Magnetic anastomosis is safe, effective, and simple for both biliojejunostomy and pancreaticojejunostomy in Whipple's procedure.
磁性吻合已应用于胆管和肠道重建。本研究旨在介绍在胰十二指肠切除术中使用磁性吻合技术行胆肠吻合和胰肠吻合的初步临床应用。
2016 年至 2017 年期间，前瞻性纳入患有壶腹周围癌和扩张胆管及胰管的患者。胰十二指肠切除术后，在近端胆管和胰管中放置合适的母磁体和引流管。将子磁体引入吻合部位与母磁体配对。密切进行术后监测，并通过引流管常规进行胆胰管造影。
纳入 1 名女性和 3 名男性患者，中位年龄 69 岁（范围，57-77 岁）。胆总管和胰管直径分别为 8-15mm 和 7-10mm。胆肠吻合和胰肠吻合的中位时间分别为 7（范围，5-8 分钟）分钟和 9（范围，8-10 分钟）分钟。胆肠吻合和胰肠吻合形成的中位时间分别为 17（范围，15-21 天）天和 11（范围，10-18 天）天。中位随访 313 天，1 例患者术后 11 个月发生胆肠吻合口狭窄，行经皮经肝引流窦道支架置入术，恢复良好。
在胰十二指肠切除术中，磁性吻合术用于胆肠吻合和胰肠吻合安全、有效且简单。
