Khirurgiia · 2006
[Duct-mucosa pancreaticojejunostomy].
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Kostov D, Kobakov G, Dragnev N
Аннотация
The subject of the study is operative-technical special features by fashioned a duct-mucosa pancreaticojejunostomy, which has been done by 15 patients. Three of the patients have been operated on a multivisceral caustic injury of an alimentary system and the rest twelve patients on a carcinoma of the pancreatic head or chronic pancreatitis. A subtotal duodenopancreatic resection has been performed on the cases with a carcinoma of the pancreatic head and chronic pancreatitis. A duodenopancreatic resection (n=3) have been done by the patients with caustic injure after a removal of an esophagus, a stomach and a part of the proximal jejunum. The operative-technical special features of the duct-mucosa pancreaticojejunostomy have been described. The postoperative mortality was 18% (n=2). The postoperative morbidity was 36% (n=4) and an anastomotic failure of the duct-mucosa pancreaticojejunostomy has been reported on two patients (18%). The consistence of the pancreas and the width of the pancreatic duct don't exert substantial influence on the leak tightness of the duct-mucosa pancreaticojejunostomy, which is an alternative operative method. A stenting of the anastomosis saves a lumen of the pancreatic duct, decreases a pressure in the jejunum and prevents an activation of the pancreatic secretion near the anastomosis.