[Experimental laparoscopic bypass of bile duct and duodenal obstruction].
In order to avoid laparotomy in patients with biliary and/or gastric outlet obstruction due to inoperable carcinoma of the pancreas, the feasibility of minimal invasive double bypass operation was evaluated in 20 pigs. In model A (n = 10) biliary bypass was performed using a Roux-en-Y loop for cholecystojejunostomy after previous choledochal clip occlusion. In mod-el B (n = 10) an additional Roux-en-Y loop was placed to the stomach after transection and closure of the duodenum.


RESULTS
Model A showed functioning biliary bypass with patent and leakfree anastomoses at necropsy at day 28. In model B nine of ten had a normal functioning double bypass. One pig was sacrificed at day 6 due to necrotic Roux-en-Y loop.


CONCLUSIONS
Laparoscopic biliary and gastroenteral bypass is feasible and safe. Laparoscopic Roux-en-Y loop technique considerably widens the spectrum of minimal invasive visceral surgery.
Departement Chirurgie, Universitätsspital, Zürich.
O
O
Schöb
R
R
Schlumpf
R
R
Schmid
C
C
Meyenberger
F
F
Largiadèr
D000713:Anastomosis, Roux-en-Y / Q000379:methods*; D000818:Animals; D002779:Cholestasis / Q000601:surgery*; D003135:Common Bile Duct / Q000601:surgery*; D005260:Female; D017219:Gastric Outlet Obstruction / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods*; D011028:Pneumoperitoneum, Artificial; D013552:Swine
Experimenteller laparoskopischer Bypass der Gallenwegs-und Duodenumobstruktion.