TECHNIQUE OF RECONSTRUCTIVE SURGERY IN RECURRENCE OF DUODENAL ULCER FOLLOWING PREVIOUS VAGOTOMY WITH GASTRODUODENOANASTOMOSIS AFTER DZHABULEY

摘要

A technique of the reconstructive surgery in recurrence of the duodenal ulcer following the previous vagotomy with gastroduodenoanastomosis after Dzhabuley comprises the closure of the duodenal stump. Furthermore, after the mobilization of antrum, degastroduodenostomy is performed and the duodenum is cut with removal of the recurrence of the duodenal ulcer and exterritorization of its crater. The duodenal defect is sutured with two-row suture. The sutures of the duodenal stump are covered with Tachocomb. Then antrumectomy is performed. The reconstructive step is ended by applying oblique-transverse gastroenteroanastomosis generating antireflux fold and enteroanastomosis.