Dimitrov V, Dudunkov Z
Khirurgiia (Sofiia). 1990;43(4):92-5.
When excision of the tumor infiltration of the duodenum is followed by formation of a small defect, the authors apply a personal modification of two-story suture. Then the duodenal suture is fully covered with the serosa of the small-intestinal loop. Thus the suture is hermetically sealed and remains in a relative rest. When a large defect remains after excision of the tumor infiltration of the duodenum, a short jejunal loop is taken and a longitudinal section is made on it of equal length with that of the duodenal defect. Laterolateral anastomosis is made between the duodenal defect and the jejunum. Brown's anastomosis is made somewhat distally from the duodenojejunostomy. In this way the duodenum is not narrowed, the tissues are sutured without any tension and postoperative duodenal stasis is minimal. The first variant of the method was applied in 3 patients and the second in 3 patients with very good postoperative result.
当十二指肠肿瘤浸润切除后形成小缺损时,作者采用了双层缝合的个人改良方法。然后,十二指肠缝合处完全被小肠袢的浆膜覆盖。这样,缝合处被严密密封并处于相对静止状态。当十二指肠肿瘤浸润切除后仍存在大的缺损时,取一段短的空肠袢并在其上做一个与十二指肠缺损长度相等的纵切口。在十二指肠缺损和空肠之间进行侧侧吻合。布朗氏吻合在十二指肠空肠吻合口稍远侧进行。通过这种方式,十二指肠不会变窄,组织缝合时没有任何张力,术后十二指肠淤滞最小。该方法的第一种变体应用于3例患者,第二种变体应用于3例患者,术后效果非常好。