Taranov I I, Chernov V N
Khirurgiia (Mosk). 1995 Jan(1):57-8.
A new method for closure of a duodenal stump in gastric resection was applied in 39 patients with giant penetrating, stenosing, and bleeding duodenal ulcers. The duodenum was cut across, 1-2 cm above the lower border of the ulcer. The first row of sutures was applied between the posterior duodenal wall, inserting the needle through the lower edge of the ulcer, and the anterior duodenal wall. Then the needle was inserted into the cut edge of the wall through the submucosa and led out through the serous coat at a distance of 0.8-1.0 cm from the edge. After tying the ligatures, the first row of sutures and the crater of the ulcer were covered with a strand of the greater omentum, whose width was no less than the diameter of the ulcer, on a nutrient supplying pedicle. The second row of sutures was placed between the upper edge of the ulcer and the anterior duodenal wall through the subserosa at a distance of 1.0-1.5 cm from the first row of sutures. The ligatures in this case pass over the strand of the greater omentum. The third row of sutures is applied between the capsule of the pancreas and the anterior duodenal wall through the subserosa for peritonization.
一种胃切除术中十二指肠残端闭合的新方法应用于39例巨大穿透性、狭窄性和出血性十二指肠溃疡患者。在溃疡下缘上方1 - 2厘米处横断十二指肠。第一排缝线在十二指肠后壁（将针穿过溃疡下缘）与十二指肠前壁之间缝合。然后，针经黏膜下层插入肠壁切口边缘，并在距边缘0.8 - 1.0厘米处从浆膜层引出。结扎缝线后，用一条有营养供应蒂的大网膜覆盖第一排缝线和溃疡面，大网膜宽度不小于溃疡直径。第二排缝线在距第一排缝线1.0 - 1.5厘米处经浆膜下层在溃疡上缘与十二指肠前壁之间缝合。此时结扎线从大网膜条上穿过。第三排缝线经浆膜下层在胰腺被膜与十二指肠前壁之间缝合以覆盖腹膜。
