METHOD FOR PANCREATODUODENAL RESECTION AT LOCAL CANCER OF PERIAMPULAR AREA AT EXTENSIVE TUMOR INVASION OF THE MAIN VEINS IN MESENTERICO-PORTAL SYSTEM

摘要

FIELD: medicine, oncosurgery.;SUBSTANCE: it is necessary to fulfill resection by a single block with pancreatoduodenal complex of portal, splenic and the upper mesenteric veins, fulfill the reconstruction of the upper mesenteric and portal veins due to direct prosthetics with synthetic conduit, which should be supplemented with compulsory reconstruction of the main circulation along splenic vein due to its prosthetics with synthetic conduit of corresponding diameter. Moreover, distal anastomosis should be formed with portal vein being above anastomosis with its prosthesis, or with prosthesis of the upper mesenteric and portal veins by "end-to-side" type. The method declared enables to fulfill adequate reconstruction of veins in mesenterico-portal system after their extensive resection, provide maximal correlation in the diameters of resected veins and conduit that enables to minimize the risk in the development of venous thrombosis in portal system after veins' reconstruction, avoid to sample autovenous conduit that shortens the duration and traumatism of operation and excludes the risk in the development of complications which are not associated with manipulations in the area of the main operation.;EFFECT: higher efficiency.;4 dwg, 1 ex