腹腔镜十二指肠空肠吻合术治疗恶性狭窄作为多模式治疗的一部分：病例报告
Laparoscopic duodenojejunostomy for malignant stenosis as a part of multimodal therapy: A case report.
作者信息
Murakami Teppei, Matsui Yugo
机构信息
Department of Surgery, Kobe City Hospital Organization Kobe City Center West Hospital, Kobe 653-0013, Hyogo, Japan.
出版信息
World J Clin Cases. 2022 Jun 6;10(16):5324-5330. doi: 10.12998/wjcc.v10.i16.5324.
BACKGROUND
Laparoscopic duodenojejunostomy (LDJ) has become the standard surgical procedure for superior mesenteric artery syndrome due to its sufficient outcome in terms of safety and symptom relief. However, there are only a few reports about LDJ for malignant stenosis and its indication remains uncertain.
CASE SUMMARY
A 77-year-old woman with a history of pancreatic cancer (PC) treated with distal pancreatectomy with resection of the transverse colon 7 mo ago was admitted for recurrent vomiting. Imaging upon admission revealed marked distention of the duodenum and a tumor around the duodenojejunal flexure. She was diagnosed with malignant stenosis caused by local recurrence of PC. LDJ was performed with an uneventful postoperative course, followed by chemotherapy which gave her 10 mo overall survival.
CONCLUSION
We think that LDJ is a valuable method for unresectable malignant stenosis around the duodenojejunal flexure as a part of multimodal therapy.
背景
腹腔镜十二指肠空肠吻合术（LDJ）因其在安全性和症状缓解方面的良好效果，已成为治疗肠系膜上动脉综合征的标准手术方法。然而，关于LDJ治疗恶性狭窄的报道较少，其适应证仍不明确。
病例摘要
一名77岁女性，7个月前因胰腺癌（PC）接受了远端胰腺切除术及横结肠切除术，现因反复呕吐入院。入院时的影像学检查显示十二指肠明显扩张，十二指肠空肠曲周围有肿瘤。她被诊断为PC局部复发导致的恶性狭窄。行LDJ手术，术后恢复顺利，随后进行化疗，患者总生存时间为10个月。
结论
我们认为，作为多模式治疗的一部分，LDJ是治疗十二指肠空肠曲周围不可切除恶性狭窄的一种有价值的方法。
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