Kum C K, Yap C H, Goh P M
Department of Surgery, National University Hospital, Singapore.
Singapore Med J. 1995 Apr;36(2):228-9.
Palliation of unresectable gastric carcinoma by conventional gastrojejunostomy is associated with significant morbidity and mortality. Laparoscopic gastrojejunostomy may be an alternative as it can achieve the same results with less morbidity. This is a case report of a 68-year-old man with an obstructed, unresectable gastric carcinoma that has metastasized to the lungs and liver. Attempt at laser boring was unsuccessful. Laparoscopic assessment revealed an immobile tumour fixed to the pancreas. A totally intraabdominal laparoscopic gastrojejunostomy was fashioned with endoGIAs (USSC Norwalk, CT). Operation time was 85 minutes. He was able to tolerate feeds on the 3rd postoperative day (POD), diet on the 5th POD and was discharged on the 8th POD. Satisfactory palliation at home was achieved for ten weeks before death. Laparoscopic gastrojejunostomy is thus a good option for palliation of obstructed advanced gastric cancer.
传统胃空肠吻合术姑息治疗不可切除的胃癌会伴有显著的发病率和死亡率。腹腔镜胃空肠吻合术可能是一种替代方法，因为它能以较低的发病率取得相同的效果。本文报告一例68岁男性患者，患有梗阻性、不可切除的胃癌，已转移至肺和肝脏。激光打孔尝试未成功。腹腔镜评估显示肿瘤固定于胰腺，无法移动。使用内镜切割吻合器（美国外科公司诺沃克，康涅狄格州）进行了完全腹腔内腹腔镜胃空肠吻合术。手术时间为85分钟。患者术后第3天能够耐受进食，第5天恢复正常饮食，并于术后第8天出院。在家中实现了十周的满意姑息治疗，直至患者死亡。因此，腹腔镜胃空肠吻合术是梗阻性晚期胃癌姑息治疗的一个良好选择。
