METHOD OF PREVENTING PANCREATITIS AND NECROSIS OF PANCREAS STUMP AFTER PANCREATODUODENAL RESECTION

摘要

FIELD: medicine.;SUBSTANCE: invention relates to medicine, surgery, in particular pancreas surgery and can be applied in order to prevent pancreatitis and necrosis of pancreas stump after pancreatoduodenal resection. For this purpose supra-median laparotomy is performed, pancretoduodenal complex is isolated and ablated. 20 cm from small intestine stump lower semi-circle of pancreas stump is sewn to intestinal wall by means of six sutures. Into pancreatic duct PVC drainage with diametre corresponding to duct diametre is introduced for 4-5 cm. Drainage tube is fixed to duct wall by means of purse-string suture. In small intestine wall puncture is made. Purse-string suture is applied. PVC drainage is passed through enterotomic opening in small intestine lumen and is brought out through stump at whose end one more purse-string suture is applied. Threads of earlier applied purse-string sutures of enterotomic opening and small intestine stump are tied. Small intestine wall is sewn to upper semi-circle of pancreas stump with six sutures. 1 In left subcostal area anterior abdominal wall is punctured. Through puncture end of PVC drainage is brought on skin. Small intestine stump is fixed with four interrupted sutures from inside to peritoneum, end of PVC drainage being fixed on skin. In the wall of PVC drainage external ring single opening with diametre constituting 1/3 of drainage diametre is made. Through the opening into drainage lumen thin ureter catheter is introduced, passed along pancreatoduodenal drainage and introduced into pancreatic duct on its full depth. To external end of ureter catheter system for infusions is switched. Drainage-washing system is adjusted.;EFFECT: increase of efficiency of pancreatitis and pancreas stump necrosis prevention after pancreatoduodenal resection.;1 ex, 4 dwg