METHOD FOR RECONSTRUCTION OF THE GASTROINTESTINAL TRACT IN PANCREATODUODENECTOMY

摘要

A method for reconstruction of the gastrointestinal tract in pancreatoduodenectomy comprises removal of gastropancreatoduodenal complex that includes the of the pancreatic head, duodenum, distal gastric sections, choledoch duct with the gall bladder and regional lymph nodes. The preservation of gastroenteroanastomosis is performed by ablation of the stomach distal to the latter and preservation of cholecystenterostomosis by preserving the gallbladder and resecting the common bile duct 1 cm distal from the mouth of cystic duct; this allows to preserve the entire initial section of the small intestine with the previously formed by-pass anastomoses; the intestine which efferent of cholecystojejunoanastomosis is dissected at a distance 40 cm distal of choletcystojejunoanastomosis, thus, gastroentero- and cholecystojejunoanastomoses are isolated in the first loop of the small intestine, respectively, the next (second) loop of the small intestine is used to form pancreatojejunoanastomosis, wherefore this second loop is led behind the colon to form a classic pancreatojejunoanstomosis under "duct-from-mucosa" principle, then the first loop of the small intestine is “included" into the gastrointestinal passage 40 cm distal of pancreatojejunoanastomosis by Roux method.