[Endoscopic biliodigestive anastomosis with the use of magnets (experimental and clinical study)]. / Endoskopicheskie biliodigestivnye anastomozy s ispolzovaniem magnitnykh élementov (éksperimentalno-klinicheskoe issledovanie).

A new type of endoscopic operations--cholecystodigestive and choledocho-hepaticoduodenoanastomoses with the use of magnetic elements are suggested as an alternative to the traditional palliative methods of treatment of obstructive jaundice with the level of obstruction below the opening of the cystic duct. Two variants of establishing postponed compression cholecystogastroanastomoses were developed in experiments on a model of obstructive jaundice in 50 unbred dogs, a variant of cholecystoentero- and enteroenteroanastomoses with the use of endoscopic techniques, which may be conducted in clinical practice. To restore internal bile drainage the following operations were carried out on 16 patients: colecystogastroanastomosis (4), cholecystoduodenonastomosis (1), choledochoduodenoanastomosis (10), hapaticoduodenoanastomosis (1). These operations were performed in patients with irresectable obstructions of the terminal part of the choledochus and a high operative risk.

Endoscopic magnetic cholecystodigestive anastomoses: personal technique for palliative treatment of distal bile duct obstruction.

A new type of endoscopic surgery (magnetic cholecystodigestive anastomoses) is presented as an alternative to conventional palliative treatment of mechanical obstruction with icterus located below the bile duct inlet. By means of endoscopic technique, two clinically usable methods of creating delayed magnetic cholecystogastric anastomoses and one modality of implanting cholecystoenteric and enteroenteric anastomosis have been worked out in the experiment conducted on 50 mongrels with mechanical icterus. Ring-shaped or rectangular magnets were implanted in the gallbladder through laparoscopic cholecystostomy. Implantation into the stomach was accompanied by simultaneous gastroscopy. In clinical conditions, four endoscopic cholecystogastric anastomoses and one cholecystoduodenal anastomosis have been performed on patients suffering from malignant obstruction of distal bile duct due to cancer of the head of the pancreas, making any radical surgery pointless. The preliminary results indicate that endoscopic magnetic cholecystodigestive anastomoses can serve as a form of palliative treatment of distal bile duct malignant obstructions.