СПОСОБ ПАНКРЕАТОДУОДЕНАЛЬНОЙ РЕЗЕКЦИИ ПРИ МЕСТНОРАСПРОСТРАНЕННОМ РАКЕ ПЕРИАМПУЛЯРНОЙ ОБЛАСТИ С ОБШИРНОЙ ОПУХОЛЕВОЙ ИНВАЗИЕЙ МАГИСТРАЛЬНЫХ ВЕН МЕЗЕНТЕРИКО-ПОРТАЛЬНОЙ СИСТЕМЫ И НАЛИЧИЕМ ДВУХ ОСНОВНЫХ СТВОЛОВ ВЕРХНЕЙ БРЫЖЕЕЧНОЙ ВЕНЫ

摘要

FIELD: medicine. ^ SUBSTANCE: invention refers to medicine, namely to surgery, can be used in surgery of local periampullary cancer with extensive tumour invasion of mesentericoportal veins. The surgery involves sleeve resection forming a single block with pancreaticoduodenal complex of main trunks of superior mesenteric vein followed by plasty and reconstruction of digestive tract. Herewith mesentericoportal venous blood flow is restored by consecutive formation of end-to-end anastomoses between trunks of superior mesenteric vein and externally reinforced synthetic polytetrafluorethylene conduirs. Further uniform conduit fistula is formed by lateral anastomosing. Anastomosis is applied between conduits and confluence of portal vein. ^ EFFECT: method allows for adequate universal mesentericoportal vein reconstruction following extensive resection with two main trunks of superior mesenteric vein observed; provides portal blood flow close to physiological due to preserving splenic vein blood flow and eliminates development of hepatic parenchyma ischemia, hepatic cell insufficiency, and vein thrombosis of operative zone. ^ 2 dwg, 1 ex