FIELD: medicine.
SUBSTANCE: when performing the reconstructive stage of pancreatoduodenal resection after disconnection of the small bowel loop by the Roux, the loop of the small bowel is formed around the stump of the pancreatic gland. Two adjacent fixed stitches are performed on the posterior leaf of the parietal peritoneum in the zone of the lower edge of the PG on the border of the mobilized part of the stump, at a distance of not more than 1 cm. Three of the four ends of threads with needles lead to the "window" of the mesentery. A serous-muscular interrupted stitch is put by two of them between the ends of the small bowel loop. Two separate semipurse-string sutures of each of the remaining threads are made along the mesovarian edge of the small bowel loop on opposite sides of the loop until the projection of the upper edge of the PG stump. At the upper edge of the PG stump, a stitch is put on the parietal peritoneum leaf. The serous-muscular interrupted stitch is tightened between the ends of the small bowel loop. The ends of the threads are the tightened and fixed in doses. The PG duct is isolatedly stitched into the wall of the diverting section of the small bowel loop. The sides of the loop are stitched together without formation of an enteroenterostomy.
EFFECT: allows to reduce the risk of postoperative complications, the anastomotic dehiscence.
1 ex, 6 dwg
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Authors
Dates
2017-10-09—Published
2016-09-20—Filed