食管吻合器用于门奇断流术的评价

Esophageal stapling in porto-azugous devascularization

门静脉高压症食管静脉曲张出血采用常规门奇断流术存在断流不彻底,再发出血率高的弊病。采用食管吻合器行食管下段钉合进行断流,有助于这一问题的解决。作者对23例食管静脉曲张出血行食管下段横断钉合及胃底贲门周围血管断流,全组无手术死亡。随访发现,3例因门静脉高压性胃粘膜病变而发生少量再出血。2例发生术后食管吻合口狭窄。作者对其原因及预防进行了讨论。

In general,the regular porto-azugous devascularization is not complete resulting in high rebleeding rate in the treatment of portal hypertension with esophageal varices.Esophageal stapling may be an effective modality to resolve this problem.23 patients were treated by using stapling to transect the esophagus after devascularization of gastric fundus and pericardia without operative mortality.All patients were followed-up.Three patients had mild rebleeding possibly caused by the gastric mucosal le- sion,The esophageal stoma stricture occurred in 2 patients.The causes and prevention of complication were discussed.