Clinical comparison of laparoscopic magnetic compression cholangiojejunostomy to laparoscopic hand-sutured cholangiojejunostomy: single center case-control study_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

ZHANG Hongke ¹ , LIU Xuemin ² , CAO Zhenjie ¹ , LÜ Yi ² ,  LI Yu ²

1. Department of Pediatric Surgery, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710061, P. R. China;
2. Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710061, P. R. China;

Corresponding author：

LI Yu, Email: liyu-820219@163.com

Keywords：

magnetic compression anastomosis; laparoscopic surgery; cholangiojejunostomy; hand-sutured anastomosis

DOI：

10.7507/1007-9424.202308059

Video：

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Objective To compare the clinical outcomes of laparoscopic magnetic compression cholangiojejunostomy (LMCCJ) with laparoscopic hand-sutured cholangiojejunostomy (LHSCJ). Methods A retrospective case-control study was performed. From January 2019 to May 2022, 37 patients, who underwent laparoscopic treatment in this hospital, were enrolled in this study. There were 16 cases in the LMCCJ group and 21 cases in the LHSCJ group. The demographic information, procedure time to complete bilioenteric reconstruction, postoperative hospital stay, operative complications, magnets expulsion time, and follow-up results were collected and analyzed. Results There were no statistical differences in the baseline data such as the gender, age, composition of primary diseases, preoperative total bilirubin, and preoperative common bile duct diameter between the two groups (P＞0.05). The outer diameter of the magnets was (10.50±0.97) mm, the expulsion time of the magnets was (49.69±37.58) d, and the expulsion rate of the magnets was 100% (16/16). There was no intestinal obstruction or gastrointestinal perforation caused by the retention of the magnets. The procedure time to complete bilioenteric reconstruction in the LMCCJ group was statistically shorter than that in the LHSCJ group [(11.31±3.40) min vs. (24.81±3.40) min, t=11.96, P＜0.01]. There was no statistical difference in the total bilirubin level at the first week after surgery between the two groups (U=142.0, P=0.80). The postoperative hospital stay in the LMCCJ group was longer than that in the LHSCJ group [(28.31±14.11) d vs. (16.19±7.56) d, t=3.36, P＜0.01]. During the perioperative period, there was no bleeding or biliary infection in the two groups, but one case of biliary leak in the LHSCJ group. In all 37 patients were followed-up for (548.8±259.2) d. During the follow-up period, the incidence rates of biliary intestinal anastomosis stenosis, tumor recurrence, and mortality had no statistical differences between the two groups (P＞0.05). Conclusion From the results of comparative analysis in this study, it can be concluded that LMCCJ is not only safe equally, but also easier and less time-consuming as compared with LHSCJ.

Citation： ZHANG Hongke, LIU Xuemin, CAO Zhenjie, LÜ Yi, LI Yu. Clinical comparison of laparoscopic magnetic compression cholangiojejunostomy to laparoscopic hand-sutured cholangiojejunostomy: single center case-control study. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2023, 30(10): 1188-1192. doi: 10.7507/1007-9424.202308059 Copy

1.	Obora Y, Tamaki N, Matsumoto S. Nonsuture microvascular anastomosis using magnet rings: preliminary report. Surg Neurol, 1978, 9(2): 117-120.
2.	Jamshidi R, Stephenson JT, Clay JG, et al. Magnamosis: magnetic compression anastomosis with comparison to suture and staple techniques. J Pediatr Surg, 2009, 44(1): 222-228.
3.	Ho YH, Ashour MA. Techniques for colorectal anastomosis. World J Gastroenterol, 2010, 16(13): 1610-1621.
4.	Pichakron KO, Jelin EB, Hirose S, et al. Magnamosis Ⅱ: magnetic compression anastomosis for minimally invasive gastrojejunostomy and jejunojejunostomy. J Am Coll Surg, 2011, 212(1): 42-49.
5.	Li Y, Sun H, Yan X, et al. Magnetic compression anastomosis for the treatment of benign biliary strictures: a clinical study from China. Surg Endosc, 2020, 34(6): 2541-2550.
6.	van Hooft JE, Vleggaar FP, Le Moine O, et al. Endoscopic magnetic gastroenteric anastomosis for palliation of malignant gastric outlet obstruction: a prospective multicenter study. Gastrointest Endosc, 2010, 72(3): 530-535.
7.	Filsoufi F, Farivar RS, Aklog L, et al. Automated distal coronary bypass with a novel magnetic coupler (MVP system). J Thorac Cardiovasc Surg, 2004, 127(1): 185-192.
8.	Vicol C, Eifert S, Oberhoffer M, et al. Mid-term patency after magnetic coupling for distal bypass anastomosis in coronary surgery. Ann Thorac Surg, 2006, 82(4): 1452-1456.
9.	张洪科, 郭华, 吕毅. 腹腔镜胆肠磁吻合器的研制. 中国医疗器械杂志, 2022, 46(6): 621-624, 628.
10.	Zhang H, Xue F, Zhang J, et al. A novel magnetic device for laparoscopic cholangiojejunostomy. J Surg Res, 2017, 218: 271-276.
11.	Li Y, Liu XM, Zhang HK, et al. Cholangiojejunostomy using a novel magnamosis device: initial clinical results. World J Surg, 2021, 45(10): 3138-3145.
12.	李宇, 刘学民, 张谞丰, 等. 胆肠磁吻合器在胆管空肠吻合中应用的临床效果. 中华外科杂志, 2020, 58(10): 798-801.
13.	Liu XM, Yan XP, Zhang HK, et al. Magnetic anastomosis for biliojejunostomy: first prospective clinical trial. World J Surg, 2018, 42(12): 4039-4045.
14.	Liu XM, Li Y, Zhang HK, et al. Laparoscopic magnetic compression biliojejunostomy: a preliminary clinical study. J Surg Res, 2019, 236: 60-67.
15.	李宇, 张谞丰, 马锋, 等. 胆肠、胰肠双磁吻合在胰十二指肠切除术中的应用. 肝胆胰外科杂志, 2020, 32(7): 395-402, 407.
16.	李宇, 刘学民, 张谞丰, 等. 磁吻合技术在腹腔镜胰十二指肠切除中应用的初步经验. 中华肝胆外科杂志, 2021, 27(1): 61-65.
17.	Fan C, Zhang H, Yan X, et al. Advanced Roux-en-Y hepaticojejunostomy with magnetic compressive anastomats in obstructive jaundice dog models. Surg Endosc, 2018, 32(2): 779-789.
18.	Xue F, Guo HC, Li JP, et al. Choledochojejunostomy with an innovative magnetic compressive anastomosis: how to determine optimal pressure?. World J Gastroenterol, 2016, 22(7): 2326-2335.
19.	Okabayashi T, Shima Y, Sumiyoshi T, et al. Incidence and risk factors of cholangitis after hepaticojejunostomy. J Gastrointest Surg, 2018, 22(4): 676-683.
20.	Zhu JQ, Li XL, Kou JT, et al. Bilioenteric anastomotic stricture in patients with benign and malignant tumors: prevalence, risk factors and treatment. Hepatobiliary Pancreat Dis Int, 2017, 16(4): 412-417.
21.	Fan C, Yan XP, Liu SQ, et al. Roux-en-Y choledochojejunostomy using novel magnetic compressive anastomats in canine model of obstructive jaundice. Hepatobiliary Pancreat Dis Int, 2012, 11(1): 81-88.

1. Obora Y, Tamaki N, Matsumoto S. Nonsuture microvascular anastomosis using magnet rings: preliminary report. Surg Neurol, 1978, 9(2): 117-120.
2. Jamshidi R, Stephenson JT, Clay JG, et al. Magnamosis: magnetic compression anastomosis with comparison to suture and staple techniques. J Pediatr Surg, 2009, 44(1): 222-228.
3. Ho YH, Ashour MA. Techniques for colorectal anastomosis. World J Gastroenterol, 2010, 16(13): 1610-1621.
4. Pichakron KO, Jelin EB, Hirose S, et al. Magnamosis Ⅱ: magnetic compression anastomosis for minimally invasive gastrojejunostomy and jejunojejunostomy. J Am Coll Surg, 2011, 212(1): 42-49.
5. Li Y, Sun H, Yan X, et al. Magnetic compression anastomosis for the treatment of benign biliary strictures: a clinical study from China. Surg Endosc, 2020, 34(6): 2541-2550.
6. van Hooft JE, Vleggaar FP, Le Moine O, et al. Endoscopic magnetic gastroenteric anastomosis for palliation of malignant gastric outlet obstruction: a prospective multicenter study. Gastrointest Endosc, 2010, 72(3): 530-535.
7. Filsoufi F, Farivar RS, Aklog L, et al. Automated distal coronary bypass with a novel magnetic coupler (MVP system). J Thorac Cardiovasc Surg, 2004, 127(1): 185-192.
8. Vicol C, Eifert S, Oberhoffer M, et al. Mid-term patency after magnetic coupling for distal bypass anastomosis in coronary surgery. Ann Thorac Surg, 2006, 82(4): 1452-1456.
9. 张洪科, 郭华, 吕毅. 腹腔镜胆肠磁吻合器的研制. 中国医疗器械杂志, 2022, 46(6): 621-624, 628.
10. Zhang H, Xue F, Zhang J, et al. A novel magnetic device for laparoscopic cholangiojejunostomy. J Surg Res, 2017, 218: 271-276.
11. Li Y, Liu XM, Zhang HK, et al. Cholangiojejunostomy using a novel magnamosis device: initial clinical results. World J Surg, 2021, 45(10): 3138-3145.
12. 李宇, 刘学民, 张谞丰, 等. 胆肠磁吻合器在胆管空肠吻合中应用的临床效果. 中华外科杂志, 2020, 58(10): 798-801.
13. Liu XM, Yan XP, Zhang HK, et al. Magnetic anastomosis for biliojejunostomy: first prospective clinical trial. World J Surg, 2018, 42(12): 4039-4045.
14. Liu XM, Li Y, Zhang HK, et al. Laparoscopic magnetic compression biliojejunostomy: a preliminary clinical study. J Surg Res, 2019, 236: 60-67.
15. 李宇, 张谞丰, 马锋, 等. 胆肠、胰肠双磁吻合在胰十二指肠切除术中的应用. 肝胆胰外科杂志, 2020, 32(7): 395-402, 407.
16. 李宇, 刘学民, 张谞丰, 等. 磁吻合技术在腹腔镜胰十二指肠切除中应用的初步经验. 中华肝胆外科杂志, 2021, 27(1): 61-65.
17. Fan C, Zhang H, Yan X, et al. Advanced Roux-en-Y hepaticojejunostomy with magnetic compressive anastomats in obstructive jaundice dog models. Surg Endosc, 2018, 32(2): 779-789.
18. Xue F, Guo HC, Li JP, et al. Choledochojejunostomy with an innovative magnetic compressive anastomosis: how to determine optimal pressure?. World J Gastroenterol, 2016, 22(7): 2326-2335.
19. Okabayashi T, Shima Y, Sumiyoshi T, et al. Incidence and risk factors of cholangitis after hepaticojejunostomy. J Gastrointest Surg, 2018, 22(4): 676-683.
20. Zhu JQ, Li XL, Kou JT, et al. Bilioenteric anastomotic stricture in patients with benign and malignant tumors: prevalence, risk factors and treatment. Hepatobiliary Pancreat Dis Int, 2017, 16(4): 412-417.
21. Fan C, Yan XP, Liu SQ, et al. Roux-en-Y choledochojejunostomy using novel magnetic compressive anastomats in canine model of obstructive jaundice. Hepatobiliary Pancreat Dis Int, 2012, 11(1): 81-88.

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CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Clinical comparison of laparoscopic magnetic compression cholangiojejunostomy to laparoscopic hand-sutured cholangiojejunostomy: single center case-control study

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