SU1558395A1 - Method of recovering common bile and pancreatic ducst in case of casual injury during the operation - Google Patents

Abstract

The invention relates to medicine, namely to surgery, and can be used in the treatment of diseases of the abdominal organs. The aim of the invention is to simplify the operation technique and reduce the risk of postoperative complications. In case of accidental damage to the common bile and virsung ducts during gastrectomy, transpapillary-transduodenal drainage of the ducts by polyvinyl drains is performed. The anterior wall of the duodenum is isolated, the intestine is crossed at the level of the upper edge of the pancreatic head. The latter is invaginated into the lumen of the duodenum by the application of bilateral serous-muscular sutures between the intestinal wall and the peritoneal cover of the pancreas and the hepatoduodenal ligament. According to the proposed method, 5 patients were operated on. The method can be recommended for practical use in gastric resection, complicated by the intersection of the common bile and Wirsung ducts.

Description

one

(21) 4309178 / 28-14

(22) 09.22.87

(46) 04.23.90. Bul Number 15

(71) Smolensk State Medical Institute

(72) B. P. Ladnyuk, Yu. I. Timofeev and V. G. Pleshkov

(53) 616.342-089 (088.8)

(56) A.A. Shalimov, V.N. Polupan. Atlas of operations on the esophagus, stomach, and duodenum.- M .: 1975, p. 262-263

(54) METHOD OF RESTORING GENERAL BILARY AND VIRSUNG CURRENTS WITH THEIR RANDOMLY DAMAGE DURING THE OPERATION

(57) The invention relates to medicine, namely to surgery, and can be used in the treatment of diseases of the abdominal organs. The aim of the invention is to simplify the operation technique and reduce the risk of postoperative complications. In case of accidental damage to the common bile and virsung ducts during gastrectomy, transpapillary-transduodenal drainage of the ducts by polyvinyl drains is performed. The anterior wall of the duodenum is isolated, the intestine is crossed at the level of the upper edge of the pancreatic head. The latter is invaginated into the lumen of the duodenum by placing double-stratal sero-muscular sutures between the intestinal wall and the peritoneal cover of the pancreas and hepatoduodenal ligament. According to the proposed method, 5 patients were operated on. The method can be recommended for practical use in gastric resection, complicated by the intersection of the common bile and Wirsung ducts. 2 yl

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The invention relates to medicine, namely to surgery, and can be used in the treatment of diseases of the abdominal organs.

The aim of the invention is to simplify the operation technique and reduce the risk of postoperative complications.

FIG. 1 and 2 represent the stages of the operation.

The method is carried out as follows.

Transpapillary-transduodenal drainage of the proximal ends crossed during gastrectomy of the common gall 1 and Wirsung 2 ducts is performed using lost polyvinyl drainages 3, which are fixed to the duct wall with a thin catgut thread. Duodenal ulcer 4 is excreted to

the confluence of the ducts and cross at the level of the upper edge of the head of the pancreas 5. The head of the pancreas, together with the drained ducts, is immersed in the lumen of the duodenum. Duplex serous-muscular sutures 6 are laid between the duodenal wall, the peritoneal cover of the pancreas, and the hepatoduodenal ligament 7. The operation is completed by the imposition of a gastroenteroanastomosis in various modifications.

Example. Sick, 48 years old. He entered the clinic with a diagnosis of duodenal ulcer disease, with compensated pyloric stenosis. During a planned operation, the cutting of the ductal gut adhesion was found. With its mobilization, the common bile and wirsuns are crossed.

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Go into the channels of the Proshve youth and drainage with polyvinyl fsn / kami. Since the scoria of the infiltragus spread to the head of the subcategory of the gland and the hepatoduodepal linkage, it was not possible to isolate the duct walls for anastomosis. The duodenum was crossed at the level of the upper edge of the pancreatic head. The latter, together with the previously drained ducts, were immersed in the intestinal lumen and fixed by the overlapping of two-row sero-muscular sutures between the duodenal wall, the peritoneal cover of the pancreas and the hepatoduodenal ligament. Gastrectomy was performed according to Billroth-P modified by Hofmeister-Fiesterer. The postoperative period is smooth. The wound healed by primary tension. Discharged in a satisfactory condition.

According to the proposed method, 5 patients were operated on. After 2 g. After the operation, the well-being of the operated patients is well.

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the neck. The method can be recommended for use in medical practice in the event of accidental damage to the common bile and vesung ducts during gastrectomy.

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Claims (1)

Invention Formula A method of restoring the common bile and virsung ducts when they are accidentally damaged during surgery, including transpapillary transduodenal drainage of ducts, characterized in that, in order to simplify the operation technique and reduce the risk of postoperative complications, the duodenum is crossed at the level of the upper edge of the head. pancreas and invaginates the latter into the lumen of the duodenum through the imposition of dvuhdnyh serous-muscular sutures between the intestinal wall and peritoneum with the lining of the pancreas with the capture of part of the hepatoduodenal ulcer. 2