METHOD OF CLOSING DUODENUM STUMP IN RESECTION OF STOMACH IN CASE OF ULCER PENETRATING INTO PANCREAS AGGRAVATED BY PANCREATIC DUCT ARROSION

摘要

FIELD: medicine. SUBSTANCE: essence of this method resides in mobilizing stomach within resection limits without transacting left stomachal vessels, transacting duodenum at level of lower edge of ulcer-affected portion, suturing anterior wall of duodenum stump to upper edge of ulcer-stricken portion by applying first row of sutures and to pancreas capsule by making second row of sutures, making transplant vascular pedicle out of descending branches of left gastric vessels and right gastric vessels anastomosing with these vessels, cutting out seromuscular graft from unchanged slightly curved portion of anthral region so that fixed contracted graft will protrude from stump suture line in all directions by 2.5 to 3.0 cm, applying and then fastening above graft to duodenum stump suture line, intestine anterior wall, pancreas capsule and hepatoduodenal ligament. EFFECT: lower rate of occurrence of duodenal stump incompetence by more reliably sealing sutures. 4 dwg