使用新型 Magnamosis 装置施行胆肠吻合术：初步临床结果。

Cholangiojejunostomy Using a Novel Magnamosis Device: Initial Clinical Results.

机构信息

Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, China.

National Local Joint Engineering Research Center for Precision Surgery & Regenerative Medicine, Xi'an, 710061, China.

出版信息

World J Surg. 2021 Oct;45(10):3138-3145. doi: 10.1007/s00268-021-06196-z. Epub 2021 Jun 23.

DOI:10.1007/s00268-021-06196-z

PMID:34160656

Abstract

BACKGROUND

Cholangiojejunostomy (CJ) is a popular operation; however, no specific anastomotic device is available. A novel magnamosis device for CJ was developed in 2017; here, we evaluated the feasibility and safety of the device.

METHODS

Between January 2017 and December 2019, 23 patients who underwent CJ using a novel magnamosis device were enrolled. For the CJ: the parent magnet was placed in the proximal duct, and the purse-string suture was tightened over the rod of the parent magnet. The magnamosis device was introduced into the jejunum, and the mandrel penetrated the jejunum at the anastomotic site, before insertion into the rod of the parent magnet. After rotating the knob, the distance between two magnets was shortened enough to achieve coupling.

RESULTS

Sixteen patients (69.6%) underwent open CJ, while 7 (30.4%) underwent laparoscopic CJ; 21 patients (91.3%) underwent choledochojejunostomy, and 2 (8.7%) underwent right or left hepatic duct jejunostomy. The mean time for completion of CJ was 9.2±2.5 min; it was significantly shorter for open CJ than for the laparoscopic way (8±1.2 min vs. 11.8±2.5 min, P<0.05). Only one patient (4.3%) suffered bile leakage after operation and was cured by conservative treatment. The magnets were discharged with a postoperative duration of 66.7±47.2 days, with a 100% expulsion rate. After a median follow-up of 15 months, only one patient (4.3%) developed inflammatory anastomotic stricture.

CONCLUSION

The novel magnamosis device is a simple, safe, and effective modality for CJ.

摘要

背景

胆肠吻合术（CJ）是一种常用的手术，但目前尚无专门的吻合器械。我们于 2017 年研发了一种新型的 CJ 吻合Magnamosis 装置，在此，我们评估了该器械的可行性和安全性。

方法

2017 年 1 月至 2019 年 12 月，我们共招募了 23 例接受新型 Magnamosis 装置 CJ 的患者。对于 CJ：将母磁体放置在近端胆管中，并通过母磁体的杆收紧荷包缝线。将 Magnamosis 装置引入空肠，芯棒在吻合部位刺穿空肠，然后插入母磁体的杆中。旋转旋钮后，两个磁铁之间的距离缩短到足以实现耦合。

结果

16 例（69.6%）患者行开腹 CJ，7 例（30.4%）患者行腹腔镜 CJ；21 例（91.3%）患者行胆肠吻合术，2 例（8.7%）患者行右或左肝管空肠吻合术。CJ 完成时间的平均值为 9.2±2.5 分钟；开腹 CJ 明显短于腹腔镜 CJ（8±1.2 分钟 vs. 11.8±2.5 分钟，P<0.05）。仅 1 例（4.3%）患者术后发生胆漏，经保守治疗治愈。磁铁在术后 66.7±47.2 天排出，排出率为 100%。中位随访 15 个月后，仅 1 例（4.3%）患者发生炎性吻合口狭窄。