PANCREATICODUODENAL RESECTION METHOD IN CASE OF LOCALLY ADVANCED CARCINOMA OF PERIAMPULLARY ZONE WITH MAJOR TUMOROUS INVASION OF MESENTRICOPORTAL SYSTEM MAIN VEINS

FIELD: medicine. ^ SUBSTANCE: sleeve resection is implemented by unit piece with pancreaticoduodenal complex of portal, superior mesenteric and splenic veins. Then their plastic reconstruction is fulfilled. In this regard an Y-shaped conduct sheet is formed extracorporally by way of skew end-side anastomosation of two autovenous or synthetical conduct sheets or their combination. After that the splenic vein is transected more distally than tumorous damage and its stump is anastomosed with the transverse end of Y-shaped conduct sheet. The portal and the superior mesenteric vein are also resected. Pancreaticoduodenal complex is amputated and firstly distal anastomose between the portal vein and the Y-shaped conduct sheet is formed, and than proximal anastomosethe superior mesenteric vein stump and the conduct sheet, at that the latter is formed after reconstruction of main spleno-portal blood flow. In special cases, in the presence of a long stump of the splenic vein it is implanted to the sidewall of the prearranged autovenous or synthetical conduct sheet before the pancreaticoduodenal complex amputation stage. After resection of the organ block with the tumor mesentrico-portak bridgework is implemented. Sequentially distal anstamose of the portal vein is constituted as well as proximal anastomose of the superior mesenteric vein with the conduct sheets ends, at that the anastomose between the superior mesenteric vein and the conduct sheet after restoration of main spleno-portal blood flow. ^ EFFECT: provision of reconstruction mesentricoportal system veins after their major resection with preservation of blood flow through splenic vein and minimisation of risk of complications. ^ 2 cl, 1 ex, 7 dwg