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首页> 外文期刊>Surgical Endoscopy >Therapeutic, prophylactic, and preresection applications of laparoscopic gastric and biliary bypass for patients with periampullary malignancy.
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Therapeutic, prophylactic, and preresection applications of laparoscopic gastric and biliary bypass for patients with periampullary malignancy.

机译：腹腔镜胃和胆道搭桥术对壶腹周围恶性肿瘤的治疗，预防和切除术应用。

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BACKGROUND: Laparoscopic bypass surgery for the palliation of gastric and biliary obstruction is associated with a rapid recovery. This study aimed to extend its application to other aspects in the management of patients with periampullary cancer. METHODS: Between 2001 and 2004, 21 patients (median age, 68 years) underwent laparoscopic gastric (n = 8), biliary (n = 5), and combined gastric and biliary (n = 8) bypass. In addition to its therapeutic role (n = 12), indications included a concomitant prophylactic gastric (n = 3) and biliary (n = 2) bypass as well as pre- 1 Whipple's relief of deep jaundice at the time of staging laparoscopy (n = 3). Construction of the biliary bypass to the gallbladder (n = 11) or bile duct (n = 2) was based on preoperative imaging. RESULTS: All procedures were completed laparoscopically. The median operating times for gastric, biliary, and combined bypass were 75, 60, and 130 min, respectively. The addition of a prophylactic bypass did not significantly prolong the operating time, as compared with a single therapeutic bypass. One patient died postoperatively of aspiration pneumonia. The postoperative hospital stay (median, 4 days) was not significantly influenced by the type of bypass. No recurrence of or new obstructive symptoms developed during the follow-up period after a therapeutic or prophylactic bypass. CONCLUSIONS: Applications of laparoscopic gastric and biliary bypass can safely be expanded to include a prophylactic role and preresection relief of obstructive jaundice. Prophylactic bypass surgery does not prolong operating time or hospital stay significantly and prevents future onset of obstructive symptoms.
机译：背景：腹腔镜旁路手术用于缓解胃和胆道梗阻与快速恢复有关。这项研究旨在将其应用扩展到壶腹周围癌患者管理的其他方面。方法：在2001年至2004年之间，对21例（中位年龄为68岁）的患者进行了腹腔镜胃镜检查（n = 8），胆道镜检查（n = 5）以及胃胆道手术（n = 8）。除了其治疗作用（n = 12）以外，适应症还包括腹腔镜检查时同时进行预防性胃（n = 3）和胆道（n = 2）搭桥术，以及1次Whipple缓解深黄疸。 = 3）。胆囊旁路术（n = 11）或胆管（n = 2）的构建是基于术前影像学。结果：所有手术均在腹腔镜下完成。胃，胆道和联合旁路手术的中位手术时间分别为75、60和130分钟。与单次治疗旁路相比，增加预防旁路不会显着延长手术时间。一名患者术后死于吸入性肺炎。术后的住院时间（中位数为4天）不受旁路类型的影响。在进行治疗或预防性旁路手术后的随访期内，未出现复发或新的阻塞性症状。结论：腹腔镜胃和胆道搭桥的应用可以安全地扩展到包括预防性作用和梗阻性黄疸的切除术前缓解。预防性搭桥手术不会延长手术时间或显着延长住院时间，并可以防止将来出现阻塞性症状。

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