Callery M P, Aliperti G, Soper N J
Department of Surgery, Washington University School of Medicine, St. Louis, Missouri.
Surg Laparosc Endosc. 1994 Apr;4(2):134-8.
A 53-year-old man on warfarin therapy for an aortic valve prosthesis suffered a massive upper gastrointestinal hemorrhage. Urgent endoscopy revealed active bleeding from the apex of a large duodenal diverticulum. Bleeding was successfully controlled with heater-probe applications, and the patient recovered uneventfully. Because of the patient's lifelong need for anticoagulation therapy, elective laparoscopic duodenal diverticulectomy was subsequently done using intraoperative endoscopic guidance. The patient returned to full activity and diet within 3 days and has remained stable during the postoperative interval. We describe here a new minimal access approach to a complicated duodenal diverticulum combining laparoscopic and endoscopic techniques.
一名53岁接受华法林治疗的主动脉瓣置换患者发生了大量上消化道出血。紧急内镜检查显示一个大的十二指肠憩室顶端有活动性出血。通过热探头应用成功控制了出血，患者顺利康复。由于患者终身需要抗凝治疗，随后在术中内镜引导下进行了择期腹腔镜十二指肠憩室切除术。患者在3天内恢复了完全活动和正常饮食，术后期间一直保持稳定。我们在此描述一种结合腹腔镜和内镜技术治疗复杂十二指肠憩室的新的微创方法。
