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随着微创技术的发展,腹腔镜胃癌手术越来越受到外科医师的重视~([1-3])。全腹腔镜下消化道重建是腹腔镜下胃癌手术的难点之一。Kanaya等~([4])2002年报告了全腹腔镜下三角吻合技术,该方法应用直线切割闭合器完成胃和十二指肠吻合。然而这种方法需要至少5次直线切割闭合操作,成本较高。笔者团队以往提出的三枪法胃十二指肠切除吻合技术操作上较困难~([5]),在此基础上笔者对该方法做了改进,形成了四枪法胃优先离断胃十二指肠吻合,自2015年6-9月施行8例,效果满意。现报告如下。
With the development of minimally invasive techniques, laparoscopic surgery of gastric cancer more and more attention by surgeons ~ ([1-3]). Complete laparoscopic gastrointestinal reconstruction is one of the difficulties in laparoscopic surgery for gastric cancer. Kanaya et al. ([4]) reported a total laparoscopic triangular anastomosis technique in 2002. The method used a linear incision closure device to complete gastric and duodenal anastomosis. However, this method requires at least 5 linear cutting and closing operations, the cost is higher. In the past, the team proposed a three-gun gastric gastroduodenal resection and anastomosis technique is more difficult to operate ~ ([5]), on this basis, the author made improvements to the method to form a four-gun stomach priority off stomach twelve The bowel anastomosis, implemented from June to September 2015 in 8 cases, the results satisfactory. The report is as follows.