METHOD FOR LAPAROSCOPIC PANCREATIC JEJUNOSTOMY IN PANCREATICODUODENAL RESECTION Russian patent published in 2015 - IPC A61B17/11 

FIELD: medicine.

SUBSTANCE: lymph node dissection of a hepatoduodenal ligament and an aortic caval space is performed. A distal end of pancreas is mobilised through 1.5-2.5cm from a resection end. An end-to-side pancreatic jejunoanastomosis with Roux jejuneal loop is created. A pancreatic stump is invaginated into an open jejuneal lumen. A posterior lip of the anastomosis is formed. The needle is first pricked in to incise a jejuneal wall along an upper edge of the pancreas at 1.2-1.5cm from the resection end top down along an anterior surface of the pancreas. The needle is pricked out on a posterior surface of the pancreatic stump. The first suture needle is pricked out on an anti-mesenteric edge of the jejuneal loop bottom up along the anti-mesenteric edge of the jejuneal loop in parallel with the intestinal axis. The jejuneal lumen is exposed. An incision length is maintained to be equal to a pancreatic diameter within the resection end. The second suture is formed at 1-1.5 cm from a resection line along a lower edge of the pancreas top to bottom. The needle is pricked out at 0.3-0.5cm from the resection end of the pancreas. Thereafter, 4-5 interrupted sutures are applied at 0.4-0.6cm on the posterior lip of the anastomosis. Then, 2-3 single interrupted sutures at 0.5cm are applied on the anterior lip of the anastomosis.

EFFECT: reducing intraoperative injuries and probability of the pancreatic fistula by performing laparoscopic pancreatic jejunostomy and forming the reliable anastomosis.

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