LAPAROSCOPY IN THE MANAGEMENT OF PANCREATIC-CANCER - ENDOSCOPIC CHOLECYSTOJEJUNOSTOMY FOR ADVANCED DISEASE

被引:117
作者
SHIMI, S [1 ]
BANTING, S [1 ]
CUSCHIERI, A [1 ]
机构
[1] UNIV DUNDEE,NINEWELLS HOSP & MED SCH,DEPT SURG,DUNDEE DD1 9SY,SCOTLAND
关键词
D O I
10.1002/bjs.1800790411
中图分类号
R61 [外科手术学];
学科分类号
摘要
Following a period of animal experimentation in pigs, a laparoscopic technique for sutured gastrointestinal and bilioenteric anastomoses was developed and its safety and efficacy tested in chronic experiments. The method involves the construction of a preformed external jamming loop knot and continuous suturing using a specially developed Endoski needle. The technique was used to construct a cholecystojejunostomy in five patients with advanced cancer of the pancreas (four hand-sutured and one stapled/sutured). Four of the patients recovered from the procedure with no complications, minimal postoperative discomfort and complete relief of their jaundice. In one patient relief of jaundice was slow due to blockage of the anastomosis by debris and blood clot; this resolved following removal of the inspissated material. This minimally invasive procedure has the potential for complete palliation with short hospital stay and avoids the hazards of endoscopic stenting such as encrustation and cholangitis.
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页码:317 / 319
页数:3
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