SU1195984A1 - Method of placing cholecystodigestive anastomosis - Google Patents

Abstract

A method of overlapping a cholecystomy digestive joint, including dissecting the wall of the gallbladder and an anastomosing organ, partial excision of the wall of the gallbladder, forming a junction, characterized in that, in order to prevent the development of ascending cholangitis, the junction of the gall bladder and your heart and the gall bladder and your heart are divided. (L cd; & 00

Description

The invention relates to medicine, namely to surgery, and can be used in the treatment of pancreatic cancer or pseudotumor pancreatitis.

The purpose of the invention is to prevent the development of ascending cholangitis.

In FIG. 1 shows a diagram of the application of cholecystic-eunal anastomosis in the neck of the bladder using the surgical stapler V.F. Gusarev; in FIG. 2 - view after surgery.

The method is as follows.

The gall bladder 1 is mobilized, branches 2 of the apparatus are carried out in sections of stitched organs. The body and bottom of the gallbladder are excised, the bed 3 of the bladder in the liver is sutured, an intestinal anastomosis 4 is applied in the area of the introduction of the suturing part of the apparatus, the leading part (not shown) of the intestinal loop is stitched with the UKL apparatus.

When performing cholecysto-gastrostomy for applying anastomosis, the branches of the stapler are similarly inserted into the sections of the gallbladder and stomach. After the anastomosis is applied, the excess tissue of the gallbladder is excised, the incision of the stomach wall is sutured.

Example. Patient G. was admitted to the hospital for obstructive jaundice. In surgery, the head of the pancreas is sharply enlarged and densified. The gallbladder and extrahepatic bile ducts are stretched tense. According to cholecystocholangiography, 5 tubular stenosis of the common bile duct was established.

Diagnosis: pseudotumor pancreatitis. Stenosis of the common bile duct. Obstructive jaundice. The gall bladder is mobilized, branches of V.F.Gusarev's stapler apparatus are introduced through incisions of the bladder and jejunum. Anastomosis is superimposed in the neck of the gallbladder, and the remaining part of the gallbladder is stitched with device 15 UKL-60 and excised. At the site of the jejunum incision, an intestinal anastomosis was applied. The postoperative period was uneventful without the development of a clinic of ascending cholangitis. After 20 three months, the patient successfully completed longitudinal pancreatojejunostomy.

The application of the proposed method allows, without increasing the injury rate of the operation, to prevent the possibility of the development of postoperative ascending cholangitis, since a significant part of the gallbladder, which is a reservoir for stagnation of the gut intestinal contents and the development of infection, is removed.

The use of this method in patients has shown significant advantages and high efficiency compared to conventional manual ₃₅ methods for applying cholecystodigestive anastomosis.

Figure 2.

VNIIIPI Order 8577

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Circulation 721 Subscription

Uzhhorod, Project 4,

Claims (1)

METHOD FOR THE APPLICATION OF A CHOLECYSTOMASIS JOINT, including dissection of the gallbladder wall and anastomosed organ, partial excision of the gallbladder wall with formation of the anastomosis, characterized in that, in order to prevent the development of ascending cholangitis, the anastomosis is formed with the neck of the gallbladder, and the rest of it is dissected. Lipchenko K.F. and Sochilov P.R. Complications of biliodegative anastomosis in tumors of the pancreatic-duodenal zone. - Bulletin of Surgery, 1978, 10, 65-69. Figure 1 with a sl>