Yamanouchi Magnetic Compression Anastomosis for Bilioenteric Anastomotic Stricture after Living-donor Liver Transplantation

Muraoka, Noriaki; Uematsu, Hideyuki; Yamanouchi, Eigoro; Kinoshita, Kazuyuki; Takeda, Taro; Ihara, Noriko; Matsunami, Hidetoshi; Itoh, Harumi

doi:10.1097/01.rvi.0000173280.56442.9e

Cited by 71 publications

(66 citation statements)

References 10 publications

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“…В частности, эффективность реконструк-ции колеблется от 41 до 61,2% с риском рецидива стриктуры в 34,3-97,4% наблюдений [10,13,16]. Помимо традиционной баллонной методики вос-становления проходимости наложенного ранее БДА «изнутри», предлагается формирование нового БДА с использованием известной методики магнитного компрессионного анастомоза [5,12,14]. Последний вариант реконструкции рекомендуется в том числе при протяженных стриктурах, когда невозможно традиционными приемами антеградно пройти в от-водящую кишку.…”

Section: рис 2 рентгенограмммы этапов процедуры (больной со стриктуunclassified

Interventional radiology in treatment of biliodigestive anastomoses strictures

Охотников

Yakovleva

Grigoriev

2016

Khir. Z. im. N.I. Pirogova

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ВведениеФормирование билиодигестивного анастомо-за (БДА) является стандартым реконструктивным вмешательством в хирургии ятрогенных поражений внепеченочного желчного дерева, частота которых достигает 0,09-3%, особенно на этапе освоения ви-деолапароскопической холецистэктомии [2,3,8].Вместе с тем реконструктивные вмешательства ведут к формированию рубцовых стриктур БДА в 10-30% наблюдений, что традиционно требует или повторных травматичных открытых хирургических вмешательств, или использования миниинвазивных эндоскопических методов, или методов интервен-ционной радиологии для устранения стриктуры [1,3,4,13,15,19]. Материал и методыПроведен ретроспективный анализ результатов использования методов интервенционной радио-логии (антеградный чреспеченочный доступ) в ре- Цель исследования. Анализ эффективности методов интервенционной радиологии с использованием антеградного чрес-печеночного доступа в лечении пациентов со стриктурами билиодигестивных анастомозов (БДА). Материал и методы. За период 2002-2015 гг. на лечении находились 24 пациента. Средний возраст больных 47,2 года. Срок образования стрик-тур после реконструктивных операций на внепеченочном желчном дереве с использованием транспеченочных каркасных дренажей составил от 9 мес до 12 лет. С целью купирования билиарной гипертензии выполняли одно-или двустороннюю чрескожную чреспеченочную холангиостомию. реканализацию стриктуры осуществляли с помощью системы катетер-проводник. Антеградную дилатацию стриктуры выполняли баллонным катетером диаметром 8 мм при рабочем давлении в баллоне до 6 атм и этапной экспозиции до 10 мин. Баллонную пластику анастомоза завершали каркасным наружновну-тренним дренированием зоны стриктуры. результаты. Восстановление проходимости зоны стриктуры БДА антеградными рентгенохирургическими методами было эффективно у 22 пациентов. В 2 наблюдениях в сроки до 1,5 года возник реци-див стриктуры, потребовавший повторной эндобилиарной реконструкции, в том числе c антеградным извлечением бло-кированного непокрытого стента у одного пациента. «Больших» постманипуляционных осложнений и летальных исходов не было. максимальный срок безрецидивного наблюдения пациента после установки непокрытого баллонорасширяемого стента в зоне гепатикоеюноанастомоза составил 11 лет. Average time from extrahepatic biliary reconstruction using transhepatic stented tubes to strictures appearance varied from 9 months to 12 years. one-and double-sided percutaneous transhepatic cholangiostomy was performed to abort biliary hypertension. Stricture recanalization was achieved using «catheter-wire» system. Antegrade dilatation of stricture was made using balloon catheter 8 mm and pressure up to 6 atm and stage exposition up to 10 minutes. Balloon repair of anastomosis was supplemented by stented outer-inner drainage of the area of stricture. Results. restoration of patency of stricture area using antegrade interventional methods was effective in 22 patients. recurrent stricture occurred in 2 cases within 1.5 years that required repeated biliary reconstruction including antegrad...

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Section: рис 2 рентгенограмммы этапов процедуры (больной со стриктуunclassified

Interventional radiology in treatment of biliodigestive anastomoses strictures

Охотников

Yakovleva

Grigoriev

2016

Khir. Z. im. N.I. Pirogova

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“…Navigation using magnetic properties was also reported by Uchiyama et al [5] in a gel model containing dispersed fine magnetic particles, and they proposed this technology for the detection and imaging of brain tumours. Paired magnets have been employed to create sutureless vascular anastomosis [6,7] in experiments involving pigs and dogs, in clinical cases to create an internal enteric fistula [8] and anastomosis for bilioenteric anastomotic stricture after living-donor liver transplantation [9].…”

Section: Introductionmentioning

confidence: 99%

Retraction by surface ferromagnetisation of target tissues: Preliminary studies on feasibility of magnetic retraction for endoscopic surgery

Wang

Tang

et al. 2007

Surg Endosc

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“…The major advantages of the MCT are that it is simple, minimally invasive and reliable. Currently, MCT is applied in esophageal atresia [5,6] , biliary stenosis [7][8][9][10][11][12] , vascular anastomosis [13][14][15][16][17][18][19] and gastro-intestinal anastomosis [20][21][22][23][24][25][26][27] . Previously, we applied Roux-en-Y choledochojejunostomy incorporating MCT for obstructive jaundice in a canine model [28] .…”

Section: Basic Studymentioning

confidence: 99%

Extrahepatic portacaval shuntviaa magnetic compression technique: A cadaveric feasibility study

Yan

Liu

et al. 2015

WJG

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Author contributions: Yan XP and Liu WY contributed equally to this work; Yan XP and Lv Y designed the study; Yan XP, Lv Y and Ma J performed the research and acquired the data; Yan XP and Li JP analyzed the data; Yan XP, Liu WY and Li JP drafted the manuscript; Yan XP, Liu WY, Ma J and Li JP contributed significantly to the revision of the manuscript. Institutional review board statement: The entire study was carried out in strict accordance with protocols approved by the Xi'an Jiaotong University Biomedical Ethics Committee (Ethics Permit Number: 2014-0303 Abstract AIM: To explore the anatomical feasibility of portacaval shunt using a magnetic compression technique (MCT) in cadavers. METHODS:Computed tomography (CT) images of 30 portal hypertensive patients were obtained. The diameters of the portal vein (PV), the inferior vena cava (IVC), and distance between the two structures were measured. Similar measurements were performed on 20 adult corpses. The feasibility of portacaval shunt based on those measurements was analyzed. First stage of the extrahepatic portacaval shunt using MCT was performed on five cadavers. Specifically, the PV and IVC were exposed through an abdominal incision of the cadavers. The parent magnet was introduced from the femoral vein and was delivered into the IVC by an anchor wire and a 5F Cook catheter. The daughter magnet was introduced into the PV through the splenic vein using an ORIGINAL ARTICLE Basic StudyExtrahepatic portacaval shunt via a magnetic compression technique: A cadaveric feasibility study technical and subject to postoperative complications. Side-to-side portacaval shunt has a high incidence of hepatic encephalopathy [2,3] . H-graft portacaval shunt, as a limited portacaval shunt, can effectively reduce the incidence of hepatic encephalopathy [4] . However, it is also technically challenging and patients who undergo the procedure must be put on long-term use of anticoagulants.The magnetic compression technique (MCT) exploits the attraction between magnets to pull together an area of ischemic necrosis and its surrounding tissue to promote healing. The major advantages of the MCT are that it is simple, minimally invasive and reliable. Currently, MCT is applied in esophageal atresia [5,6] , biliary stenosis [7][8][9][10][11][12] , vascular anastomosis [13][14][15][16][17][18][19] and gastro-intestinal anastomosis [20][21][22][23][24][25][26][27] . Previously, we applied Roux-en-Y choledochojejunostomy incorporating MCT for obstructive jaundice in a canine model [28] . We also confirmed that magnetic rings could be used for rapid vascular reconstruction in a canine liver transplantation model [19] . We first reported the establishment of a portacaval shunt using MCT in dogs, the significant advantage of which is that no stent or any other foreign device was installed [29] . In the present study, we assessed some anatomical parameters that might affect the establishment of extrahepatic portacaval shunt using MCT in humans, and performed five preliminary cadaveric s...

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Yamanouchi Magnetic Compression Anastomosis for Bilioenteric Anastomotic Stricture after Living-donor Liver Transplantation

Cited by 71 publications

References 10 publications

Interventional radiology in treatment of biliodigestive anastomoses strictures

Interventional radiology in treatment of biliodigestive anastomoses strictures

Retraction by surface ferromagnetisation of target tissues: Preliminary studies on feasibility of magnetic retraction for endoscopic surgery

Extrahepatic portacaval shuntviaa magnetic compression technique: A cadaveric feasibility study

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