METHOD FOR SURGICAL TREATMENT OF PROLONGED STRICTURES OF TERMINAL DEPARTMENT OF CHOLEDOCHUS AND FAILURE OF MAJOR DUODENAL PAPILLA IN PATIENTS WITH CHRONIC DUODENAL OBSTRUCTION

摘要

FIELD: medicine, surgery. ^ SUBSTANCE: the present innovation deals with surgical correction of cicatricial stricture of intrapancreatic department of choledochus or sphincter's failure of major duodenal papilla at the background of chronic duodenal obstruction. It is necessary to apply anastomosis between choledochus and duodenum. At first, one should completely withdraw inferior horizontal duodenal branch from-under mesenteric root of small intestine followed by crossing choledochus in intrapancreatic part. Then in area of "mesenteric" edge of inferior duodenal angle one should develop a foramen to apply a mobilized choledochal end through it and apply it crosswise the duodenal log. Then one should fix posterior wall of choledochal stump towards duodenal wall. The walls should be fixed together by closing them around choledochus. Then it is necessary to lance duodenal lumen to form an end-loop choledochoduodenoanastomosis with a single-row precision suture, put this anastomosis with a double-row suture into the fold between duodenal walls. The innovation enables to achieve reconstruction of biliary outflow into duodenum, prevents the onset of duodenobiliary reflux and removes chronic duodenal obstruction. ^ EFFECT: higher efficiency of therapy. ^ 13 dwg, 2 ex