Method for carring out omentobursostomy in the treatment of acute necrotizing pancreatitis

摘要

The invention refers to medicine, particularly to surgery and can be used for treating acute necrotizing pancreatitis.Summary of the invention consists in that it is introduced the laparoscope into the abdominal cavity, under its control through the left and right hypochondriums it is introduced into the abdominal cavity a drainage tube directed towards the greater curvature of stomach, then the laparoscope is removed, in the epigastric region on the median line it is made a laparotomic approach of 3,0...3,5 cm, through which by distension there are exteriorized from the abdominal cavity a portion of the greater curvature of stomach with the gastrocolic ligament and the distal ends of the drainage tube introduced into the abdominal cavity, then in the said ligament it is made a hole of 2,0...2,5 cm, through which it is aspirated the exudate from the omental bursa, on the lateral sides of said hole it is made a hole, through which there are introduced into the omental bursa the distal ends of the drainage tubes, where one end is directed towards the head of pancreas and the other end towards the tail. Near the laparotomic approach it is introduced into the omental bursa a trocar for the operating tool, afterwards the margin of the greater curvature of stomach is sutured to the peritoneum and aponeurosis, and the gastrocolic ligament - to the peritoneum for omentobursostomy formation. Round the perimeter of stoma it is applied a provisional suture, the ends of which are left outside the wound, through stoma it is introduced a trocar, which is tightened and hermetically sealed by means of the provisional suture, through the trocar it is introduced the laparoscope, it is created the omentopneumoperitoneum, and with the help of the operating tool there are carried out the surgical manipulations on pancreas, then it is untied the provisional suture and it is removed the laparoscope, through stoma into the omental bursa it is introduced a gauge tent with application of dressing.