СПОСОБ ИНТРАОПЕРАЦИОННОГО ДРЕНИРОВАНИЯ ПАНКРЕАТИЧЕСКОГО ПРОТОКА ПРИ РАКЕ ПОДЖЕЛУДОЧНОЙ ЖЕЛЕЗЫ

摘要

FIELD: medicine, surgery. ^ SUBSTANCE: at the first stage of operative treatment at the background mechanical jaundice one should intrasurgically apply an ultrasound sensor upon pancreatic tissue in omental bursa to puncture pancreatic duct and drain it; pancreatic capsule should be sutured above the tube for the length of 5 mm being perpendicular to pancreatic axis. Then one should apply the second single semi-purse-string suture for the length of 5 mm below the tube and parallel to the greater curvature of stomach. It is necessary to cross and tighten 3-4 branches of gastro-omental arteries and veins at gastric wall. With the first ligature one should suture gastric wall perpendicular to the greater curvature at the length of 5 mm towards the lesser curvature. One should apply the tube that drains pancreatic duct onto gastric wall being parallel to the first suture. As for the third suture, it should be applied by suturing gastric from the right and from the left against drainage tube for the length of 5 mm from each side. The third ligature should be tightened at a drainage tube. Gastric wall should be sutured along the greater curvature with the second ligature from the right and from the left against tightened third suture. The first and second ligatures should be tightened up by fixing gastric wall towards pancreatic capsule in area of drainage. The latter should be withdrawn onto the skin to be fixed there. At the second stage after pancreatoduodenal resection it is necessary to form a fistulogastroanastomosis by applying gastric wall around the tube. The innovation enables to develop conditions for forming reliable pancreatic anastomosis at the second stage of surgical treatment that enables to prevent pancreatitis of pancreatic stump. ^ EFFECT: higher efficiency of draining. ^ 4 dwg, 1 ex