METHOD OF SURGICAL TREATMENT OF EXTERNAL FISTULA OF DUODENUM Russian patent published in 2009 - IPC A61B17/00 

FIELD: medicine.

SUBSTANCE: duodenal fistula is exsected. Thus after supramedian laparotomy, having receded for 0.5 cm from edges of an external fistulous aperture, bordering cut of a skin and subject tissues to fascia is made. Surgery field restriction by sterile napkins is erformed. Fistulous course is painted with a methylene dark blue. Tissues surrounding to the fistulous course to an internal aperture of a fistula of a duodenum are dissected. A duodenum is mobilised according Koecher. The intestine is stitched on border of the janitor and an upper-horizontal duodenum department. Tissues are dissected between mechanical seams. With the help of a purse-string suture the mechanical seam is immersed in the duodenum. Grey-serous Z-shaped seam is imposed. Mechanical seam of a stomach is immersed using applying of separate noose sutures. The internal fistulous aperture is diagnosed. Having receded from it on 0.5 cm, duodenal fistula is exsected together with a duodenum wall. Preparation of a fistulous course with a dermal flap and duodenal tissues is removed. Edges of the duodenal wound are processed by a spirituous chlorhexidine solution. Noose sutures are imposed on a wound in a cross-section direction. Having receded 1 cm from a lateral noose suture, the second row of nodal grey-serous seams in longitudinal direction to perpendicularly first row of seams is imposed. The distance between second row seams makes 0.5 cm. The length of the second row of seams is peer to length of the first row. Having receded from the second longitudinal seam more lateral than 0.5 cm applying of the third grey-serous number of seams in length 1.5 cm is more than length of the previous is made, turning duodenum walls. The subhepatic space is drained. Surgical wounds are taken in layer by layer.

EFFECT: way provides preventive maintenance of purulent-septic complications in an abdominal cavity and in retroperitoneal space, reliable hermetic sealing of an intestine, is less traumatic, is simple in execution.

4 ex, 1 ex