Document Detail


Magnetic compression biliary-enteric anastomosis for palliation of obstructive jaundice: initial clinical results.
MedLine Citation:
PMID:  19393505     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To report initial clinical experience with a nonsurgical method for sutureless biliary-enteric anastomosis with use of two magnetic elements that potentially overcomes the disadvantages of other palliative methods. MATERIALS AND METHODS: The technique involves percutaneous transhepatic insertion of one magnet into the bile duct under fluoroscopic guidance and insertion of a second magnet endoscopically into the duodenum. The adherence of the two magnets creates ischemic necrosis of bile duct and duodenal walls. When these tissues slough, the resulting hole allows enteric passage of the magnets and creates a biliary-enteric fistula for decompression of an obstructed biliary system. A magnetic compression biliary-enteric anastomosis (MCBEA) was created in 34 patients (nine men; mean age, 64 years; age range, 46-82 y) with malignant obstructive jaundice at the level of the middle or distal common bile duct. RESULTS: There was no recurrent jaundice during the initial 30 postprocedural days. Total bilirubin levels decreased significantly in all patients 1 week after MCBEA formation (P < .0001), with normalization of bilirubin levels in eight of 34 patients. There was temporary occlusion caused by partial clogging of the bypass with coarse food in two cases, which was successfully revised endoscopically. Three patients required surgical revision as a result of tumor ingrowth. Median survival time was 10 months. The cause of death in all patients was progression of underlying malignancy. CONCLUSIONS: Creation of a biliary-enteric anastomosis with magnetic compression is a feasible alternative for palliative treatment of obstructive jaundice with satisfactory results.
Authors:
Michael Avaliani; Nikolay Chigogidze; Andrei Nechipai; Boris Dolgushin
Related Documents :
7244705 - Limitations of ultrasonography in evaluating patients with jaundice or cholecystectomy.
16866865 - Salvage of a massive esophago-tracheal fistula resulting from a stenting treatment.
7676495 - Biliary tract complications after orthotopic liver transplantation. endoscopic approach...
17354125 - Endoscopic ultrasound-guided transesophageal cholangiodrainage and consecutive endoscop...
9609285 - Surgical experience with an implanted artificial cervical joint.
20223595 - Surgical modalities in the treatment of bone sarcoma in children.
Publication Detail:
Type:  Clinical Trial; In Vitro; Journal Article    
Journal Detail:
Title:  Journal of vascular and interventional radiology : JVIR     Volume:  20     ISSN:  1535-7732     ISO Abbreviation:  J Vasc Interv Radiol     Publication Date:  2009 May 
Date Detail:
Created Date:  2009-04-27     Completed Date:  2009-07-09     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9203369     Medline TA:  J Vasc Interv Radiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  614-23     Citation Subset:  IM    
Affiliation:
Blokhin Russian Oncology Research Center, Russian Research Centre of Surgery, Moscow, Russia.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Anastomosis, Surgical / instrumentation*,  methods
Compressive Strength
Equipment Design
Humans
Jaundice, Obstructive / diagnosis*,  rehabilitation*
Magnetics / instrumentation*
Male
Middle Aged
Palliative Care
Pilot Projects
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Localized scleroderma: a series of 52 patients.
Next Document:  The effect of hepatic radiofrequency ablation on stem cell trafficking in the rat model.