| 摘要 |
FIELD: medicine.SUBSTANCE: anterior abdominal wall is incised. A distal fragment of the pancreatic gland is mobilised. The Roux enteric loop is cut out. This loop is delivered behind the transverse colon. An end of the anastomosed enteric loop is mobilised at a distance twice as much as an end of the distal fragment of the pancreatic gland. The first line of sutures is applied on the intestine at a distance twice as much as than on the pancreatic gland from the edge. Applying the first line of sutures uses 1/3 of the enteric diameter. Applying the second line of a posterior wall of the anastomosis involves opening it at 1/3 diameters. The intestinal section is formed at the level of the pancreatic section. The rest portion of the small intestine is transected directly above a clamp. A transaction line of the rest portions of the small intestine is delivered along mesenteric and antimesenteric borders of the posterior wall of the anastomosis obliquely between angular sutures and clamps. Thus formed is the excessive anterior wall of the small intestine. Edge sutures of the second line of the anterior wall of the anastomosis on the gland are arranged along its edge directly at the line of the former sutures. And on the small intestine - along the mesenteric and antimesenteric borders. The needle is pricked out on the small intestine at 1 cm from the former suture line. The edge sutures are tied up by the excessive intestinal wall both along the length, and along the width, the pancreatic gland is freely invaginated into the enteric lumen. The wound edges are closed.EFFECT: method provides the simplified application of pancreatojejunoanastomosis, an improvement of its durability, prevention of complications by adjusting the dimensions of the transected pancreatic gland and anastomosed enteric loop, as well as free invagination of the gland into the intestinal lumen, application of the durable two-line sutures.3 ex |
