| 摘要 |
A technique for pancreatogastroduodenal resection comprises laparotomy, en-block separation and removal of duodenum with antral division of the stomach, the head of pancreas, the gall bladder, the distal part of hepatobiliary duct, and the initial division of the intestine. The precision terminolateral pancreatoenteroanastomosis is fashioned at the distance of 7- from the oral end of the intestinal loop passed in the window of the mesocolon on the right. To the pancreatic duct, the catheter with lateral perforations is passed. The distal end of said catheter is passed into intestine via enterotomic aperture followed by fashioning hepatoenteroanastomosis at the distance of 5- from pancreatoenteroanastomosis, anastomosis of the oral end of the intestinal loop with the intestinal loop downstream hepatoenteroanastomosis, gastroanastomosis on the separate loop passed through mesentery of the transverse colon, and anastomosis between afferent and efferent intestinal loops at the almost equal distances from anastomosed organs. The distal end of the catheter draining the pancreatic duct is exteriorized through the stump of the bile duct and puncture site on the anterior abdominal wall. The catheter is fastened to the stump of the gallbladder duct with circular catgut suture and to the skin at the puncture site with lavsan suture. |
