Phillips E, Hakim M H, Saxe A
Department of Surgery, Sinai Hospital, Detroit, MI 48235.
Surg Endosc. 1994 Jun;8(6):686-8. doi: 10.1007/BF00678567.
We investigated laparoendoscopy (laparoscopy-assisted small bowel enteroscopy) as an aid in managing the challenging diagnostic problem of occult small bowel hemorrhage. We performed laparoendoscopy on five nonconditioned dogs and five conditioned dogs. In each case, we laparoscopically inspected the small bowel from the ligament of Treitz to the ileocecal valve. Small bowel was exteriorized, an enterotomy was performed, and an Olympus CL-100L colonoscope was inserted and advanced proximally to the stomach and distally to the ileocecal valve. A segment of small bowel was arbitrarily designated as the site of bleeding, was exteriorized, and was resected. Bowel continuity was restored with a stapled anastomosis. The animals were euthanized and autopsied immediately after the procedure (n = 5) or a week following the procedure (n = 5), at which time the anastomoses were tested for leakage and patency. The entire small bowel was visualized in all animals. There were no anastomotic leaks. Laparoendoscopy may be of value in identifying and treating hemorrhagic origin of small bowel. Clinical trials are warranted.
我们研究了腹腔镜内镜检查术（腹腔镜辅助小肠镜检查）在处理隐匿性小肠出血这一具有挑战性的诊断问题时的辅助作用。我们对五只未做预处理的犬和五只做了预处理的犬进行了腹腔镜内镜检查术。在每例手术中，我们通过腹腔镜从屈氏韧带至回盲瓣对小肠进行检查。将小肠外置，进行肠切开术，插入一台奥林巴斯CL - 100L型结肠镜并向近端推进至胃，向远端推进至回盲瓣。任意指定一段小肠作为出血部位，将其外置并切除。用吻合器吻合恢复肠道连续性。术后立即（n = 5）或术后一周（n = 5）对动物实施安乐死并进行尸检，此时对吻合口进行渗漏和通畅性检测。所有动物的整个小肠均清晰可见。未出现吻合口漏。腹腔镜内镜检查术在识别和治疗小肠出血源方面可能具有价值。有必要开展临床试验。
