METHOD FOR FORMATION OF SUPRA-PAPILLARY TRANSIVERTICULAR CHOLEDOCHODUODENAL ANASTOMOSIS UNDER CONTROL OF ENDOSCOPIC ULTRASONOGRAPHY WITH EXTENDED STRICTURE OF DISTAL COMMON BILE DUCT AND GREATER DUODENAL PAPILLA Russian patent published in 2024 - IPC A61B17/11 A61B17/94 A61B8/12 A61B17/64 A61B17/3209 

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to surgery, gastroenterology and endoscopy, and can be used in surgical treatment of extended strictures of distal common bile duct and greater duodenal papilla. Under ultrasonographic imaging through the lumen of the diverticulum, the absence of interposition of the pancreatic parenchyma and the Wirsung duct between the walls of the bile duct and the diverticulum is determined. A common bile duct is punctured through a diverticulum wall with a needle inserted through a working channel of the duodenoscope. A needle electrode is used to dissect walls of the diverticulum and common bile duct for 25–30 mm to create a fistula between the lumen of the diverticulum and the common bile duct. Along the perimeter of the created fistula between the intestine and the common bile duct, their walls are closed with endoclips.

EFFECT: method is less traumatic, does not require prolonged general anaesthesia with artificial pulmonary ventilation, reduces the duration of the operation, eliminates the risk of mechanical and thermal damage to the mouth of the Wirsung duct, reduces the risk of postoperative complications, eliminates risk of stagnation of food masses in lumen of diverticulum with development of fermentative processes due to formation of fistula under visual control by means of duodenoscopy and ultrasonography.

1 cl, 2 ex