Saveliev V S, Avaliani M V, Bashirov A D
Dept. of Faculty Surgery, Russian State Medical University, Moscow.
J Laparoendosc Surg. 1993 Apr;3(2):99-112.
A new type of endoscopic surgery (magnetic cholecystodigestive anastomoses) is presented as an alternative to conventional palliative treatment of mechanical obstruction with icterus located below the bile duct inlet. By means of endoscopic technique, two clinically usable methods of creating delayed magnetic cholecystogastric anastomoses and one modality of implanting cholecystoenteric and enteroenteric anastomosis have been worked out in the experiment conducted on 50 mongrels with mechanical icterus. Ring-shaped or rectangular magnets were implanted in the gallbladder through laparoscopic cholecystostomy. Implantation into the stomach was accompanied by simultaneous gastroscopy. In clinical conditions, four endoscopic cholecystogastric anastomoses and one cholecystoduodenal anastomosis have been performed on patients suffering from malignant obstruction of distal bile duct due to cancer of the head of the pancreas, making any radical surgery pointless. The preliminary results indicate that endoscopic magnetic cholecystodigestive anastomoses can serve as a form of palliative treatment of distal bile duct malignant obstructions.
一种新型的内镜手术（磁控胆囊消化道吻合术）被提出，作为对胆管入口以下伴有黄疸的机械性梗阻进行传统姑息治疗的替代方法。通过内镜技术，在对50只患有机械性黄疸的杂种犬进行的实验中，研究出了两种临床上可行的建立延迟性磁控胆囊胃吻合术的方法以及一种植入胆囊肠吻合术和肠肠吻合术的方式。通过腹腔镜胆囊造口术将环形或矩形磁体植入胆囊。在植入胃的过程中同时进行胃镜检查。在临床情况下，已对因胰头癌导致远端胆管恶性梗阻、无法进行任何根治性手术的患者实施了4例内镜胆囊胃吻合术和1例胆囊十二指肠吻合术。初步结果表明，内镜磁控胆囊消化道吻合术可作为远端胆管恶性梗阻的一种姑息治疗方式。
