METHOD FOR SEALING DUODENUM STUMP IN RESECTING STOMACH AFFECTED BY POST-BULB PENETRATING ULCER IN STOMACH PESTERIOR WALL

摘要

FIELD: medicine, particularly, surgery. SUBSTANCE: this method prescribes mobilizing stomach and duodenum up to lower edge of ulcer-affected region without dissecting left stomachic vessels, incising intestine at level of lower edge of ulcer, suturing anterior wall of intsetine to lower edge of ulcer by making separate sutures 1 and to upper edge of ulcer by making second row of sutures, molding vascular pedicle from descending branches of left gastric vessels 3 and anastomosing right gastric vessels 4, cutting out seromuscular graft 6 from intact minor-curvature portion of antral region of stomach section to be surgically removed. Dimensions of this graft must be such that fixed graft will protrude from stump suture line by 2.5 to 3.0 cm in all directions. Finals steps are placing graft on stump and fixing it to row of sutures 2 of intestine anterior wall 7, pancreatic capsule and hepatoduodenal ligament 9. EFFECT: lower incompetence of duodenum stump due to more reliable sealing. 4 dwg