METHOD FOR SURGICAL MANAGEMENT OF COMPLICATED GIANT DUODENAL ULCERS Russian patent published in 2019 - IPC A61B17/00 

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to surgery, and can be used for surgical management of complicated giant duodenum ulcers with manifested paracystic cicatrical-inflammatory infiltrate fixing duodenum in subhepatic space and pancreas. Anterior wall and mucous-submucous layer of posterior gut wall are mobilised. Transverse intersection of an anterior wall of duodenum is 1.5–2.0 cm above the lower edge of the ulcer to create an excess of the intestinal wall and mobilization of the posterior wall mucosa by 0.5–1.0 cm from the lower edge of the ulcer. Intestinal lumen is closed with a continuous suture of nonabsorbable material 4/0 on an atraumatic needle, starting with mobilized mucosa; the suture is applied longitudinally relative to the pancreas axis from the middle of the posterior semi-circle of the stump to the middle of the anterior semi-circle. Second row of sutures is performed with two semi-cake sutures, starting from gripping the muscular layer on the demucosated portion of the posterior wall of the intestine with immersing the anterior wall; the semi-citrine sutures are fastened with immersion and tightening of the stump to the head of the pancreas. Additionally, two semi-filament sutures of an anterior intestinal wall are applied with a lower fibrous edge of the ulcer.

EFFECT: method increases reliability of sealing, reduces injuries.

1 cl, 4 dwg