METHOD FOR SURGICAL MANAGEMENT OF EXTERNAL PANCREATIC FISTULAS

摘要

FIELD: medicine.;SUBSTANCE: invention refers to surgery, and may be applied for surgical management of pancreatic fistulas. Two vicryl sutures are used to fix two points of an external edge of a drain to an edge of fistula walls. Free suture ends are tied together, and a guide is formed. A purse-string suture is applied circumferentially on a mucous membrane of a defunctionalised loop of a small intestine from the side of its lumen at 2 cm from a resected edge, the suture ends are delivered through a outer wall puncture. The intestinal edge is invaginated in its lumen below a level of the purse-string suture. The free ends of the guide sutures are delivered through the lumen of the defunctionalised loop of the small intestine and delivered outside at 5-6 cm from the invaginate edge through the puncture of the intestinal wall. The invaginate of the defunctionalised loop of the small intestine is matched with a fistula stump. A compression end-to-end fistuloenteroanastomosis with the loop of the intestinal wall is formed. The drainage is left in the anastomosis lumen to its healing.;EFFECT: method allows reducing a risk of exocrine disorders, inflammatory and purulent complications.;4 dwg