FIELD: medicine.
SUBSTANCE: method involves dissecting duodenum wall free of ulcer defect to semicircle to mucous membrane. The mucous membrane is separated from seromuscular cuff and dissected. The incision is continued from the open space side along the lower ulcer boundary. The mucous cylinder semicircle is closed. The detached mucous cylinder of the stump is sutured with interrupted sutures. Sutures line is directed in perpendicular to seromuscular cuff and gastroduodenal anastomosis suture lines. Free cuff wall edge is sutured to muscle edge of the opposite wall isolated from ulcer fundus. When forming the first row of seromuscular sutures of posterior anastomosis lip, the gastric wall, posterior seromuscular cuff stump semicircle, and anterior intestine wall are sutured in series. Duodenal stump duplicature is concurrently formed. Longitudinal duodenotomy is carried out. Internal row of posterior and anterior anastomosis lips are formed. External row of anterior anastomosis lip is formed.
EFFECT: avoided tissue strain in anastomosis zone, twist of pancreas head and invaginated portion in the stump.
2 dwg
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Authors
Dates
2006-10-10—Published
2005-02-28—Filed