Department of Hepatobiliary Surgery and Institute of Advanced Surgical Technology and Engineering, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province, China; Shaanxi Provincial Regenerative Medicine and Surgical Engineering Research Center, Xi'an, Shaanxi Province, China.
Department of Hepatobiliary Surgery and Institute of Advanced Surgical Technology and Engineering, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province, China.
J Surg Res. 2019 Apr;236:60-67. doi: 10.1016/j.jss.2018.11.010. Epub 2018 Dec 7.
Magnetic compression anastomosis is a feasible and effective method for bilioenteric anastomosis (BEA) in animal model. The objective of the present study was to report our initial clinical experience in laparoscopically magnetic compression bilioenteric anastomosis (LMC-BEA).
Patients with obstructive jaundice who were candidates for LMC-BEA were prospectively enrolled from 2013 to 2015. All the procedures were performed laparoscopically. A mother magnet and drainage tube were placed in the proximal bile duct and tightened by a purse suture after dissection of the common bile duct. The drainage tube was introduced into the jejunal lumen at the anastomotic site and guided a daughter magnet to approximate the mother magnet. The two magnets mated at the anastomotic site. All the patients were routinely followed up for magnets discharge till the end of the study.
In total, four patients with malignant obstructive jaundice and one patient with benign biliary stricture were included. The median age was 70 y (range, 49-74 y). The median time for LMC-BEA was 12 min (range, 8-15 min). A complete anastomosis was confirmed after a median time of 21 d (range, 5-25 d) postoperatively by cholangiography via drainage tube. The magnets were expulsed around 41 d after surgery (range, 12-47 d) postoperatively. With a median follow-up of 313 d (range, 223-1042 d), no complications associated with magnetic anastomosis was documented, such as bile leakage or anastomotic stricture.
Magnetic compression is a promising alternate method for laparoscopic BEA. Among the five patients undergoing LMC-BEA, no one developed anastomotic complications.
磁压缩吻合术是一种在动物模型中用于胆肠吻合术（BEA）的可行且有效的方法。本研究的目的是报告我们在腹腔镜磁压缩胆肠吻合术（LMC-BEA）中的初步临床经验。
2013 年至 2015 年，前瞻性招募了适合行 LMC-BEA 的梗阻性黄疸患者。所有手术均在腹腔镜下进行。在解剖胆总管后，将母磁铁和引流管放置在近端胆管中，并通过荷包缝线收紧。将引流管引入吻合部位的空肠腔，并引导子磁铁接近母磁铁。两个磁铁在吻合部位配合。所有患者均常规随访磁铁排出情况，直至研究结束。
共有 4 例恶性梗阻性黄疸患者和 1 例良性胆管狭窄患者纳入本研究。中位年龄为 70 岁（范围 49-74 岁）。LMC-BEA 的中位时间为 12 分钟（范围 8-15 分钟）。通过引流管行术后中位 21 天（范围 5-25 天）的胆管造影确认完全吻合。术后中位 41 天（范围 12-47 天）排出磁铁。中位随访 313 天（范围 223-1042 天）期间，未记录到与磁性吻合相关的并发症，如胆漏或吻合口狭窄。
磁压缩是腹腔镜 BEA 的一种有前途的替代方法。在接受 LMC-BEA 的 5 例患者中，没有 1 例发生吻合口并发症。
