Kron B, Reynier J
Int Surg. 1985 Apr-Jun;70(2):133-7.
After experimental study in the dog, which showed the material to be highly reliable, an original method of biliary bypass using a silicone prosthesis in the treatment of neoplastic jaundice is introduced. This prosthesis allows the bile duct to be bypassed regardless of the location of the obstacle. This method was used in 150 patients; recession was sufficiently good in 84 of them to confirm good tolerance and the excellence of the results. In fact, good results were recorded in 95% of cases of cancer of the hilum, which is all the more remarkable in consideration of the difficulties involved in these operations. The main postoperative complications are bile fistulas which resolve spontaneously if the precaution of extensively draining the zones of intubation is taken; postoperative comfort is excellent; no constraint is necessary and the operative risk is moderate, this is particularly desirable in patients in a poor general condition. A short prosthesis makes transtumoral intubation possible, and a long prosthesis allows implantation in the digestive tract: stomach, duodenum or first intestinal loop. Postoperative persistence of jaundice is rare if a prosthesis of sufficient diameter is used and if no major bile duct or part of the liver is excluded. Cholangitis is exceptional and indicative of an excluded biliary area.
在对狗进行的实验研究表明该材料高度可靠之后，介绍了一种使用硅胶假体进行胆旁路手术治疗肿瘤性黄疸的原创方法。这种假体能够绕过胆管，而不管障碍物的位置如何。该方法应用于150例患者；其中84例的消退情况良好，足以证实耐受性良好且效果卓越。事实上，在肝门癌病例中，95%取得了良好效果，鉴于这些手术存在的困难，这一点尤为显著。主要的术后并发症是胆瘘，如果采取在插管区域广泛引流的预防措施，胆瘘会自行消退；术后舒适度极佳；无需限制，手术风险适中，这对于一般状况较差的患者尤为可取。短假体使经肿瘤插管成为可能，长假体则允许植入消化道：胃、十二指肠或第一肠袢。如果使用足够直径的假体且没有排除主要胆管或部分肝脏，术后黄疸持续的情况很少见。胆管炎很罕见，表明存在排除的胆管区域。
