FIELD: medicine, surgical gastroenterology. SUBSTANCE: one should carry out cross- sectional duodenotomy by keeping a bulboduodenal sphincter. Duodenotomic level - the border of middle and distal thirds of a bulb. Small intestine should be crossed 10- 15 cm distally against duodenojejunal transition. Antiperistaltic end-to-end jejunoduodenoanastomosis between distal end of small intestine and duodenal postbulbary level. Pyloric duodenal part is passed through mesenteric "fenestrum" of small-intestinal transplant, end-loop bulboenteroanastomosis is developed by leaving 6 cm against the line of anastomosis application. The loop of small intestine is fixed along bulb's perimeter. Small-intestinal lumen is lanced, adjacent ends of both a bulb and small intestine are compared. Anterior anastomosis wall is developed with one- row serous-muscularsubmucous sutures. Crossed part of small intestine is anastomosed into transplant's side by forming jejunojejunoanastomosis being distally against Treitz ligament. The innovation provides optimal duodenal draining. EFFECT: higher efficiency of operation. 1 cl, 20 dwg, 2 ex
