METHOD FOR GASTRIC RESECTIONS AT COMPLICATED DUODENAL ULCERS Russian patent published in 2003 - IPC

FIELD: medicine, surgery. SUBSTANCE: one should carry out distal tubular gastric resection, form muscular pulp at distal end of gastric stump. Ulcer is removed out of duodenal lumen, duodenal stump is sutured. Gastrojejunoanastomosis is formed by forming double-lumen invagination-valvular anastomosis. At 12-15 cm distance against Treitz ligament one should mobilize jejunal loop. At the middle of mobilized part serous-muscular membrane should be circularly dissected. Distally and proximally against incision it is necessary to perform two resections of serous- muscular membrane by making ellipsoidal shape. Between distal and proximal incisions one should remove serous-muscular membrane at the half of intestinal circumference. Sutures are applied between inferior edge of posterior semicircumference of pulp and proximal edge of serous-muscular membrane of deserosed part. Mucous-submucous cylinder is arranged onto deserosed part of jejunum. Cylinder is anastomosed at the level of central dissection. Sutures are applied between inferior edge of anterior semicircumference of pulp and distal edge of serous-muscular membrane. One should continue application of similar sutures along the rest part of jejunal circumference. The present innovation provides prophylaxis of postgastroresectional disorders. EFFECT: higher efficiency. 6 dwg