TECHNIQUE FOR RECONSTRUCTIVE SURGERY WITH FASHIONING INTESTINAL RESERVOIR FOLLOWING GASTRECTOMY ACCORDING TO ROUX AND DUODENAL SWITCH

摘要

The technique for the reconstructive surgery with fashioning intestinal reservoir following gastrectomy according to Roux and duodenal switch provides for fashioning intestinal reservoir. The efferent loop of jejunum is cut proximal to Roux enteroanastomosis. Distal to esophagojejunoanastomosis, the efferent loop of jejunum is folded in U-shape as the double loop and sutured along 12- using the stapler. Then the segment of jejunum is tailored along 22- distal to Roux enteroanastomosis on the vascular mesenteric arcade. The tailored segment is transferred proximally retrocolic. Its oral end 10- in length is anastomosed with jejunum segment sutured in U-shaped mode generating the artificial intestinal reservoir (jejunogastroplasty) from the triple jejunal loop. The distal end of the segment tailored from jejunum is anastomosed with the stump of duodenum with the aid of the circular stapler "Ethicon" generating jejunoduodenoanastomosis. The efferent loop of the jejunum is plugged proximal to Roux enteroanastomosis. The continuity of jejunum is restored with end-to-end Roux enteroanastomosis.