METHOD OF APPLICATION OF BILIODIGESTIVE ANASTOMOSIS

摘要

FIELD: medicine. ^ SUBSTANCE: invention pertains to medicine, in particular to surgery of hepatobiliary region and may be used in application of biliodigestive anastomosis to internal bile flow in inoperable patients with malign tumors of proximal biliary ducts complicated with mechanic jaundice. Biliodigestive anastomosis is formed in the liver portae by conducting anastomosis of tubular structures. Biliary duct is exposed. Transhepatic drainage after Pradery is conducted with a thread been applied on its intestinal end forming an impression before hand. Diverticular bulging is formed on the intestine by resection of serous-muscular plate of 0.5 cm diametre. Purse-string suture is applied on the apical part of the diverticular bulging. Drainage is conducted through a perforated opening of the diverticulum. Purse-string suture is tightened on the applied thread of the drainage. Mucus of the intestine is pulled into the biliary duct lumen by traction of the drainage in proximal direction without application of apposition sutures. Wall of the intestine is sutured with 4-5 stitches, going through its serous-muscular layer to the hepatic capsule. ^ EFFECT: method ensures prevention of intestine fistulas, biliodigestive anastomosis failure through reliable fixation of mucous on the drainage without application of opposition sutures and failure of microcirculation therein. ^ 4 dwg