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经皮内镜下引流胃造口术治疗腹腔恶性肿瘤所致胃肠道梗阻

Percutaneous endoscopic drainage gastrostomy in the treatment of gastrointestinal obstruction from intraperitoneal malignancy.

作者信息

Adelson M D, Kasowitz M H

机构信息

Department of Obstetrics and Gynecology, State University of New York Health Science Center, Syracuse, New York.

出版信息

Obstet Gynecol. 1993 Mar;81(3):467-71.

PMID:7679789
Abstract

We evaluated the effectiveness of a percutaneous technique for placement of a drainage gastrostomy. Progressive dilatation of the abdominal and gastric walls was used to place a Malecot catheter (28 French). Endoscopic guidance assured proper placement and assisted in the dilatation. Fourteen drainage gastrostomy tubes were placed in 12 patients. The tube could not be placed in on additional patient with tumor infiltration into the anterior gastric wall. No surgical complications occurred, but there was one postoperative complication, peritonitis treated with antibiotics without catheter removal. All catheters provided unobstructed drainage and decompression of gastrointestinal obstruction. Percutaneous endoscopic drainage gastrostomy seems to be an effective means of palliating small-bowel obstruction and its complication rate appears low. This method may be suitable to replace open laparotomy techniques for gasrostomy placement.

摘要

我们评估了一种经皮放置引流胃造口术的有效性。采用逐步扩张腹壁和胃壁的方法放置一根28F的马勒科特导管。内镜引导确保了正确放置并辅助扩张。12例患者共放置了14根引流胃造口管。有1例胃前壁受肿瘤浸润的患者未能放置导管。未发生手术并发症,但有1例术后并发症,即腹膜炎,经抗生素治疗后未拔除导管。所有导管均实现了通畅引流并解除了胃肠道梗阻。经皮内镜引流胃造口术似乎是缓解小肠梗阻的一种有效方法,其并发症发生率似乎较低。这种方法可能适合替代开放剖腹手术放置胃造口术。

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