СПОСОБ БИЛИАРНОЙ РЕКОНСТРУКЦИИ ПРИ ОРТОТОПИЧЕСКОЙ ТРАНСПЛАНТАЦИИ ЛЕВОГО ЛАТЕРАЛЬНОГО СЕКТОРА ПЕЧЕНИ ДЕТЯМ ПРИ НАЛИЧИИ У ТРАНСПЛАНТАТА ОБЩЕГО УСТЬЯ ЖЕЛЧНЫХ ПРОТОКОВ II И III СЕГМЕНТОВ ПЕЧЕНИ ПО ГОТЬЕ
FEDERALNOE GOSUDARSTVENNOE BJUDZHETNOE UCHREZHDENIE "FEDERALNYJ NAUCHNYJ TSENTR TRANSPLANTOLOGII I ISKUSSTVENNYKH ORGANOV IMENI AKADEMIKA V.I. SHUMAKOVA" MINISTERSTVA ZDRAVOOKHRANENIJA ROSSIJSKOJ FEDE
发明人:
GOTE SERGEJ VLADIMIROVICH,Готье Сергей Владимирович,MONAKHOV ARTEM RASHIDOVICH,Монахов Артем Рашидович,AKHALADZE DMITRIJ GURAMOVICH,Ахаладзе Дмитрий Гурамович,KHIZROEV KHIZRI MAGOMEDOVICH,Хизроев Хизр
申请号：
RU2014107719/14
公开号：
RU0002549016C1
申请日:
2014.02.28
申请国别(地区):
RU
年份:
2015
代理人:
摘要：
FIELD: medicine.SUBSTANCE: end-to-side bioliodigestive anastomosis is created between a common orifice of bile ducts of the II and III liver segments of the transplant and recipients Roux-defunctioned jejunal loop. When taking a left lateral liver sector from the donor, a round ligament of liver at least 7 cm long is left on the transplant. After forming an opening in an intestinal wall, an intestinal mucosa is fixed along the opening borders to a serous-muscular layer. An anastomosis is created between the opening formed in the intestine and the common orifice of bile ducts. The intestine is fixed to the transplant at a distance from the anastomosis angles. The round ligament of liver is laid on an anterior lip of the anastomosis, and a distal end of the ligament is fixed to the transplant. For particular cases: the common orifice is dilated by dissecting a bile wall within the common orifice by 2-4 mm along a pathfinder 1-1.5 mm in diameter inserted preliminary into the common orifice. An opening is formed in an antimesenteric edge of the intestine. The mucous membrane is fixed to the serous-muscular layer along the intestinal opening borders with 3-6 single interrupted sutures. The biliodigestive anastomosis is formed with single interrupted sutures. Fixing the intestine is ensured by anchoring together with the serous-muscular layer at 4-8 mm from each of the anastomosis angles to the liver capsule or a connective tissue plate, wherein the bile ducts of the transplant pass. A distal end of the round ligament of liver is fixed with one or two sutures to the liver capsule or connective tissue plate, wherein the bile ducts of the transplant pass. The distal end of the round ligament of liver is fixed to the transplant with the sutures fixing the intestine to the transplant. If the orifices of bile ducts of the transplanted II and III liver segments are arranged separately at min. 3 mm from each other, the adjoining bile walls are sutured together to create a common
