Fabbri Nicolò, Ferro Silvia, Bagolini Francesco, Romeo Luigi, Carcoforo Paolo, Giorgio Cavallesco, Pansini Giancarlo
Unit of General Surgery, Azienda USL di Ferrara, Ferrara, Italy.
Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara, Italy.
Gland Surg. 2020 Oct;9(5):1298-1304. doi: 10.21037/gs-20-387.
Since the first years of the 1980s, some authors described the use of mechanical stapler for the creation of anastomosis in biliary surgery. However, the use of these devices has not spread during the following decades, and nowadays most centers usually craft hand-sewn anastomosis.
We retrospectively collected data from medical records, surgical registries and computerized databases about the use of mechanical circular staplers for the creation of hepaticojejunostomy at our institution.
From 2012 to 2020, 11 stapled hepaticojejunostomy for both neoplastic and non-neoplastic diseases were performed at our institution. The mean age of the patient was 74, with a sex distribution of 5 men and 6 women. The mean preoperative common bile duct diameter was 19 mm. Preoperative blood samples showed mean total bilirubin of 6.95 mg/dL. No intraoperative complications were reported. Two patients (18%) had minor postoperative complications (1 wound dehiscence and 1 episode of melena that required blood transfusions), while no major complications occurred. No patients developed biliary fistula or anastomotic dehiscence. No one dies within 30 days from surgery. The mean postoperative length of stay was 13 days.
According to our limited experience, stapled hepaticojejunostomy seems to be a safe and effective technique in selected patients.
自20世纪80年代初以来，一些作者描述了在胆道手术中使用机械吻合器进行吻合术。然而，在接下来的几十年里，这些器械的使用并未普及，如今大多数中心通常采用手工缝合吻合术。
我们回顾性收集了来自病历、手术登记册和计算机数据库的关于在我们机构使用机械圆形吻合器进行肝空肠吻合术的数据。
2012年至2020年，我们机构对肿瘤性和非肿瘤性疾病共进行了11例吻合器辅助肝空肠吻合术。患者的平均年龄为74岁，性别分布为5名男性和6名女性。术前胆总管平均直径为19毫米。术前血液样本显示总胆红素平均为6.95毫克/分升。未报告术中并发症。两名患者（18%）出现轻微术后并发症（1例伤口裂开和1例需要输血的黑便），但未发生重大并发症。没有患者发生胆瘘或吻合口裂开。术后30天内无人死亡。术后平均住院时间为13天。
根据我们有限的经验，吻合器辅助肝空肠吻合术在选定患者中似乎是一种安全有效的技术。
