将解剖胆道重建作为选择性病例的终极避难所--历史与现状。

IF 3.2 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY
Jan Sevcik, Maria Stefania Massaro, Richard Palek, Vladimira Moulisova, Vaclav Liska
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引用次数: 0

摘要

肝外胆管重建是高胆固醇胆管炎手术的主要程序。目前大多数病例的标准是非解剖性胆肠重建,这对大多数患者来说是一个令人满意的选择。然而,它不能用于少数选择性病例(短肠综合征、严重腹腔粘连),在这些病例中,可以使用带或不带中间膜的解剖重建。本综述总结了近 100 年来有关实验和临床解剖胆管重建的组织和材料使用的现有知识。我们在 Pubmed 数据库中搜索了从 1920 年到 2022 年在实验和临床环境中发表的有关解剖性肝外胆管重建的文章。迄今为止,尚未找到真正理想的内膜材料。不过,有证据显示了这种材料的重要特性,其中最重要的是它的生物降解性和受体体内的新生血管。内胆管支架在解剖重建中的作用似乎对结果非常重要。肝外胆管解剖重建是一种不常见的技术,但在无法进行非解剖重建的特殊病例中却很实用。用于解剖胆管重建的interponate材料的最佳特性已更加明确,但仍需进一步研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Anatomical biliary reconstruction as an ultimum refugium for selective cases-History and current state of knowledge.

Reconstruction of extrahepatic bile ducts is a staple procedure of HPB surgery. The current standard for most cases is a nonanatomical bilioenteric reconstruction, a satisfactory option for the majority of patients. However, it cannot be used for a small number of selective cases (short bowel syndrome, severe abdominal adhesions), where an anatomical reconstruction with or without an interponate can be used. This review summarizes current knowledge about tissue and material usage for experimental and clinical anatomical bile duct reconstruction in the last 100 years. A Pubmed database was searched for published articles about anatomical extrahepatic bile duct reconstruction in experimental and clinical settings ranging from 1920 to 2022. To date, the truly optimal interponate material has not yet been found. However, evidence reveals important properties of such material, most importantly its biodegradability and neovascularization in the recipient's body. The role of internal bile duct stenting for anatomical reconstruction seems important for the outcome. Anatomical reconstruction of extrahepatic bile ducts is an uncommon but usable technique in unique cases when a nonanatomical reconstruction cannot be done. The optimal properties of interponate material for anatomical bile duct reconstruction have been more clarified, although further research is required.

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来源期刊
Journal of Hepato‐Biliary‐Pancreatic Sciences
Journal of Hepato‐Biliary‐Pancreatic Sciences GASTROENTEROLOGY & HEPATOLOGY-SURGERY
自引率
10.00%
发文量
178
审稿时长
6-12 weeks
期刊介绍: The Journal of Hepato-Biliary-Pancreatic Sciences (JHBPS) is the leading peer-reviewed journal in the field of hepato-biliary-pancreatic sciences. JHBPS publishes articles dealing with clinical research as well as translational research on all aspects of this field. Coverage includes Original Article, Review Article, Images of Interest, Rapid Communication and an announcement section. Letters to the Editor and comments on the journal’s policies or content are also included. JHBPS welcomes submissions from surgeons, physicians, endoscopists, radiologists, oncologists, and pathologists.
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