腹腔鏡下に流入・流出静脈を切除した十二指腸静脈瘤の1例

A case of duodenal varices:Treatment by laparoscopic varicose vein resection

　患者は67歳，女性．気分不良，冷汗，タール便を主訴に近医を受診した．緊急内視鏡検査で十二指腸下行脚に出血源である静脈瘤を指摘され，クリッピングで止血された．全身状態の改善ののち，手術を施行した．手術は腹腔鏡下に行い，静脈瘤をその流入部でクリップで結紮し，中枢側も結紮したのち切除を行った．経過は順調であり，術後の内視鏡では十二指腸潰瘍を認めたものの静脈瘤は完全に消失していた．本術式は十二指腸静脈瘤に対する治療法の1つの選択肢となると考えられた．

A case of duodenal varices successfully treated by laparoscopic resection, is reported. A 67 years-old female was admitted to the hospital because of a tarry stool. An emergent endoscopic examination revealed F1 varices in the duodenum and massive bleeding. The duodenal varices were treated by endoscopic clipping. After the general condition become stable, an operation was performed by laparoscopic resection. The postoperative course was uneventful, and postoperative endoscopic findings showed extinction of duodenal varices. Laparoscopic approach was considered useful for excision of duodenal varices.