METHOD FOR SURGICAL TREATMENT OF PANCREATIC DUCT LITHIASIS Russian patent published in 2024 - IPC A61B18/26 A61B8/12 A61F2/04 A61B17/3209 

FIELD: medicine.

SUBSTANCE: invention relates to abdominal surgery. Major pancreatic duct (MPD) is dissected longitudinally under ultrasound control. Antegrade laparotomic or laparoscopic approach to the MPD is formed. Omental sac is opened. Pancreas is mobilized. Ultrasound-guided puncture of the MPD is performed in the distal direction from the concrement located in the duct, revealing the initial point of the pancreaticotomy. Longitudinal dissection of the pancreatic parenchyma and MPD is performed with length of 1.5–2 cm in the distal direction from the puncture needle. Working portion of the endoscopic system SpyGlass is introduced into the produced MPD defect. Calculus is visualized. Laser lithotripsy and lithoextraction are performed through the working channel of the SpyGlass endoscope. It is followed by retrograde stenting of the MPD with insertion of a guide through the greater duodenal papilla behind the MPD defect using duodenoscopy. Plastic stent with a diameter exceeding the lumen of the MPD in the area of the stenosis is placed along the guidewire, in the distal direction from defect by 2–3 cm. MPD defect is closed with interrupted sutures.

EFFECT: method makes it possible to cure patients with pancreatic duct lithiasis, complicated by pronounced bends or narrowings of the MPD, which prevent retrograde insertion of the endoscopic instrument, reduce injuries and number of postoperative complications.

2 cl, 5 dwg, 2 ex