Zhang Miao-Miao, Tao Jie, Sha Huan-Chen, Li Yun, Song Xiao-Gang, Muensterer Oliver J, Dong Fang-Fang, Zhang Li, Lyu Yi, Yan Xiao-Peng
Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, Shaanxi Province, China.
Shaanxi Provincial Key Laboratory of Magnetic Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, Shaanxi Province, China.
World J Gastrointest Surg. 2024 Jun 27;16(6):1933-1938. doi: 10.4240/wjgs.v16.i6.1933.
The combination of magnetic compression anastomosis (MCA) and endoscopy has been used to treat biliary stricture after liver transplantation. However, its use for the treatment of complex biliary obstruction after major abdominal trauma has not been reported. This case report describes the successful use of MCA for the treatment of biliary obstruction resulting from major abdominal trauma.
A 23-year-old man underwent major abdominal surgery (repair of liver rupture, right half colon resection, and ileostomy) following a car accident one year ago. The abdominal drainage tube, positioned at the Winslow foramen, was draining approximately 600-800 mL of bile per day. During the two endoscopic retrograde cholangiopancreatography procedures, the guide wire was unable to enter the common bile duct, which prevented placement of a biliary stent. MCA combined with endoscopy was used to successfully achieve magnetic anastomosis of the peritoneal sinus tract and duodenum, and then a choledochoduodenal stent was placed. Finally, the external biliary drainage tube was removed. The patient achieved internal biliary drainage leading to the removal of the external biliary drainage tube, which improved the quality of life.
Magnetic compression technique can be used for the treatment of complex biliary obstruction with minimal operative trauma.
磁压缩吻合术（MCA）与内镜检查相结合已被用于治疗肝移植术后的胆管狭窄。然而，其用于治疗重大腹部创伤后复杂胆管梗阻的情况尚未见报道。本病例报告描述了MCA成功用于治疗重大腹部创伤所致胆管梗阻的情况。
一名23岁男性一年前因车祸接受了重大腹部手术（肝破裂修复、右半结肠切除及回肠造口术）。置于网膜孔的腹腔引流管每天引流出约600 - 800毫升胆汁。在两次内镜逆行胰胆管造影术中，导丝无法进入胆总管，这妨碍了胆管支架的置入。MCA联合内镜检查成功实现了腹膜窦道与十二指肠的磁吻合，随后置入了胆总管十二指肠支架。最后，拔除了体外胆管引流管。患者实现了胆管内引流，从而拔除了体外胆管引流管，改善了生活质量。
磁压缩技术可用于治疗复杂胆管梗阻，手术创伤极小。
