TECHNIQUE FOR RECONSTRUCTIVE SURGERY WITH FASHIONING INTESTINAL RESERVOIR FOLLOWING GASTRECTOMY ACCORDING TO ROUX AND DUODENAL SWITCH IN ACUTELY BLEEDING GASTRIC CANCER

摘要

The technique for the reconstructive surgery with fashioning intestinal reservoir following gastrectomy according to Roux and duodenal switch in the acutely bleeding gastric cancer provides for cutting the afferent loop of the jejunum. The efferent loop of jejunum is cut proximal to Roux enteroanastomosis. The jejunum is cut behind Treitz ligament 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 12- in length 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 continuity of jejunum behind Treitz ligament is restored with end-to-end Roux enteroanastomosis.