METHOD FOR FORMING ROTATIONAL PANCREATOENTEROANASTOMOSIS ON FULFILLING RIGHT-HAND PANCREATIC RESECTIONS

摘要

FIELD: medicine, surgical pancreatology.;SUBSTANCE: on fulfilling right-hand pancreatic resection it is necessary to form a Rou-isolated ansa of small intestine, its length being 60 cm. One should apply seros-pancreatocapsular sutures between the capsule of pancreatic stump and lateral surface of Rou-isolated small intestine at the border of its proximal third. Proximal part of isolated intestine should be arranged arch-shapely. Moreover, the cupola of the present intestinal segment should be projected being 3 cm distally against the suture applied. One should transversely dissect small intestine to apply the second row of pancreatoenteroanastomosis along circumference of pancreatic stump's section. Then one should apply sero-serous suture along mesenteric edge of Rou-isolated small intestine starting 2 cm distally against the line of pancreatoenetroanastomosis. The suture should be completed being 3 cm proximally against anastomosis. The suture should be tightened by covering and strengthening the lower angle of anastomosis. Then one should apply proximal part of Rou-isolated small intestine onto anterior surface of pancreatic stump, apply seroso-pancreocapsular sutures starting from the lower edge of pancreatic stump up to its upper edge between adducting department of Rou-mobilized small intestine and stump's capsule, apply sero-serous sutures between anti-mesenteric surfaces of adducting and abducting parts of Rou-mobilized small intestine. Moreover, one should start suturing 3 cm proximally against the line of pancreatoenteroanastomosis to complete it 2 cm distally against pancreatoenteroanastomosis, apply four sero-serous sutures between proximal and distal parts of Rou-mobilized small intestine at the distance of 1 cm distally against the applied pancreatoenteroanastomosis. The innovation in question decreases the risk of the onset of different post-surgical complications due to decreasing traumatism and excluding the devascularization of pancreatic edge.;EFFECT: higher efficiency.;1 ex