SU1700576A1 - Method for substituting the common bile duct with a small intestine graft - Google Patents

Abstract

The invention relates to medicine, namely to surgery, and can be used for plastic operations on the bile ducts. The aim of the invention is the prevention of postoperative complications and recurrence of the disease. The method includes excision of the affected area of the common bile duct, resection of the initial section of the small intestine with the isolation of an isolated segment on the vascular tubercle. Then, the upper end of the drainage tube is inserted into the proximal choledochus and carried out transhepatic to the outside, the lower end of the tube is held distal to cases, not income up to the sphincter of Oddi, after which the upper and lower anastomoses of the small intestinal segment with hophopathis are formed. The proposed method is effective and can be used along with other methods

Description

The invention relates to medicine, namely to surgery, and can be used in plastic operations on the bile ducts,

The aim of the invention is the prevention of postoperative complications and recurrence of the disease.

The method is carried out as follows.

The distance from the initial part of the small intestine is 15 cm, the small intestinal segment is resected, which is long - corresponding to the length of the affected area of the OPC, with preserved mesenteric vessels. The continuity of the intestinal tract is restored by an ana- metasis end-to-end. The segment is dissected longitudinally from two sides, the distance from the mesenteric edge is 3 cm, depending on the diameter of the OGP. This forms a rectangular flap, which is then sutured.

around a silicone tube with a diameter corresponding to the diameter of the choledoch. The latter is separated from the surrounding tissues and the area corresponding to the length of the lesion is excised. The ends of the choledoch are held on handles. The upper end of the drainage tube, worn on a metal probe, is held in the proximal part of the common bile duct and then through the right lobar duct, the right lobe of the liver is brought to the diaphragmatic surface. A needle suture is applied around the exit of the tube to the liver. The proximal ends of the choledochus and the intestinal segment are anastomized. The lower end of the drainage tube is led to the distal section of the OPD. no income to the sphincter of Oddi. Then, a lower anastomosis is applied between the small bowel segment and the choledochus. The portion of the drainage tube located in

X |

cl

XI o

The bile flux x has holes pre-applied in the order.

After the operation, the bile is o (it is driven as a duodenum, a hook and outward. Drainage is removed after 1 month.

Example 1. Dog number 15, weighing 20 kg. Under intratracheal anesthesia, the mid-abdominal skin incision is opened by the abdominal cavity. After preparation of a rectangular enteric flap, built from an isolated thin-tooth segment on the supply leg and restoration of the continuity of the niche, the area 2 cm long was excised from the choledochus. on the diaphragmatic surface and further through the subcutaneous tunnel on the scruff of the neck. Rana saojn- ia tightly. The wound healed by primary tension. Observation of the animal was 3 months. The dog was cheerful, well ala. During the first month, every three days, the drainage tube was washed with warm saline. On cholangiogrammes marked with normal graft patency. The animal was slaughtered after 3 months. At the autopsy. Macroscopically and microscopically, the wall of the graft was not observed.

PRI me R 2, NH7 Dog, weighing 18 k. Under intratracheal anesthesia, the abdominal cavity was opened by a midline incision. A 2 cm long choledsch site is replaced by a small bowel transplant cut from a segment. At the same time, frame drainage was used, the upper end of which was conducted through the right lobar aperture, the liver, and further through the subcutaneous tunnel displayed on the nape. The lower end of the tube held in the distal segment of OGP, not income to the sphincter of Oddi. The wound is sewn tightly. Grub removed after 1 month. During this time, the drainage was washed with warm saline. On cholangiogramma marked with the free passage of contrast into the duodenum. The dog was tracked for 6 months. Blood biochemical parameters remained within the normal range. At the opening, the permeability of the grasplanat was established.

Example Dog number 23, weighing 18 kg.

Under intraracheal anesthesia, the abdominal cavity is opened by a midline incision. The segment of the choledochus 2 cm long is replaced by a small bowel transplant cut from the segment. In this case, skeleton drainage was used, the upper end of which was conducted through the proximal segment of the common bile duct, the right lobar duct, the liver, and then through the subcutaneous tunnel is displayed on the back of the neck. The lower end of the tube held in

distal segment of OZhP, not income to the sphincter of Oddi. The wound is sewn tightly. felling removed after 1 month. During this time, the drainage was washed with warm saline,

On cholangiogramma marked with the free passage of contrast into the duodenum. The dog is traced for 1 month. Biochemical parameters remained within the normal range. At the dissection, the patency of the graft and anastomoses was established macroscopically.

Thus, the present invention is an effective method and does not deny the use of other methods.

replacement of the common bile duct. The obtained results allow us to suggest the implementation of this method in the clinic.

Claims (1)

Invention Formula The way to replace the common bile duct small intestinal graft, including excision of the affected area of the common duct, resection of the initial section of the small intestine with the release 0 isolated segment on the vascular pedicle in an experimental animal characterized in that, with the prevention of postoperative complications and relapse of the disease, from the enteric 5 segments cut out a rectangular flap, sutured it under the diameter of the choledoch on a silicone drain tube, carried out retrogradely transhepatic, and then impose anastomoses of the proximal and distal ends of the common 0 bile duct with graft.