METHOD OF SURGICAL TREATMENT OF COMPLICATED LOW DUODENAL ULCER LOW ASSOCIATED WITH LARGE AND SMALL DUODENAL PAPILLA INVOLVEMENT

摘要

FIELD: medicine; surgery. ^ SUBSTANCE: duodenum radical excision is carried out within its cicatricial-ulcer involvement followed with subsequent duodenoplastics. Thus large and small duodenal papillas are separated from cicatricial-ulcer centre. Duodenum cicatricial-modified tissues are dissected by lesser curvature, anterior wall, and posterior wall in interpapilla interval preserving neuromuscular bridge by large curvature and lateral part of duodenum posterior wall. Large duodenal papilla is dissected from duodenum distal end with part of duodenal wall. Duodenal distal end is shifted in oral direction and implanted with large duodenal papilla through posterior wall puncture. Posterior anastomosis line is formed from bridge medial edge centre using tissues preliminary taken out from under duodenum distal end mesentery root. Small duodenal papilla or Santorini's duct is implanted to posterior wall of duodenal anastomosis; and angle anastomosis of duodenum anterior lateral walls. ^ EFFECT: method enables to reliably eliminate complications of duodenum ulcer and to achieve patient's high life quality. ^ 1 ex, 5 dwg