FIELD: medicine.
SUBSTANCE: invention relates to surgery and can be applicable to radical duodenoplasty by a continuous two-level seam in a perforated anterior wall ulcer of the duodenal bulb. Cross front wall of the bulb of the duodenum transversely through the center of the perforation, cranially and caudally to the boundary of perifocal infiltration. Excision of the ulcerative defect is done orally and aborally. Under visual control along the boundary of the ulcer crust and periulcenary edema, a continuous serous-muscular-submucous suture is applied in the transverse direction to the axis of the organ. First stitch of the continuous seam is made on the cranial corner of the formed intestinal wound, tying the first knot “fixer”, restoring the integrity of the peritoneal cover of the intestinal wall, then apply 4-5 stitches of a continuous, wrap-around screw-in serous-muscular-submucosal suture that does not penetrate into the lumen of the intestine, last stitch is produced on the caudal corner of the formed intestinal wound, the thread is tightened until the tissues come in contact and form a second knot- “fixer” then the same thread in the opposite direction at a distance of 0.5 cm from the first seam line is immersed with the last shuttle gray-serous suture, tightening until the fabrics come into contact and binding the end of the thread to the filament of the first knot-“fixer”.
EFFECT: method allows to reduce risk of damage to the pylorus, to create conditions for regeneration.
1 cl, 5 dwg
