Cholecystojejunostomy Y-shaped anastomosis

1. In the early stage of cancer around the head of the pancreas or the ampulla, it can not be tolerated once to complete the pancreatic head resection, which can be performed in several stages. For the first time, the jejunal jejunal y-shaped anastomosis was performed first. After 2 weeks, the condition improved, and the second stage pancreatic head resection was performed. 2. Congenital stenosis of the common bile duct accompanied by gallbladder swelling. 3. The lower end of the common bile duct obstruction, thickening of the common bile duct stenosis caused by stones or inflammation, the expansion is not significant, but the gallbladder is unobstructed. Treatment of diseases: pancreatic head cancer, gallbladder carcinoid Indication 1. In the early stage of cancer around the head of the pancreas or the ampulla, it can not be tolerated once to complete the pancreatic head resection, which can be performed in several stages. For the first time, the jejunal jejunal y-shaped anastomosis was performed first. After 2 weeks, the condition improved, and the second stage pancreatic head resection was performed. 2. Congenital stenosis of the common bile duct accompanied by gallbladder swelling. 3. The lower end of the common bile duct obstruction, thickening of the common bile duct stenosis caused by stones or inflammation, the expansion is not significant, but the gallbladder is unobstructed. Surgical procedure 1. Cut the upper part of the jejunum: 15cm away from the duodenal suspensory ligament in the upper part of the jejunum, pay attention to the distribution of mesangial blood supply, and use the intestinal clamp and duodenal clamp respectively to ensure the blood supply at both ends of the cut jejunum. The proximal and distal ends of the jejunum are cut, and the jejunum and its mesentery are cut off to prevent the contents of the intestine from overflowing. 2. Gallbladder jejunal anastomosis: The transverse mesenteric membrane was cut in the avascular region on the right side of the middle cerebral artery, and the distal end of the jejunum was lifted through the mesenteric incision to the gallbladder, and the bottom end of the gallbladder was anastomosed. The distal wall of the jejunum of the duodenal clamp was cut and the intestinal clamp was removed. The needles at the two corners of the jejunum are fixed at the bottom of the gallbladder, and the suture is used as the traction. The filaments are used as the anastomosis between the two traction lines, and the outer layer of the posterior wall is continuously sutured, or the muscle layer is interrupted. Stitching. The gallbladder was cut parallel at a distance of 0.5 cm from the suture, and the size of the incision was equivalent to the diameter of the jejunum port. The bile is sucked, and the thin wire is continuously locked to suture the inner layer of the posterior wall of the anastomosis. After sewing the inner layer of the posterior wall of the anastomosis, the suture is turned to the front, and the full-layer continuous sinus suture method is used to continue suturing the inner layer of the anterior wall of the anastomosis. The outer layer of the anterior wall of the anastomosis was sutured with a thin wire for the muscle layer. After the anastomosis is completed, check the patency of the anastomosis. 3. Jejunum jejunum anastomosis: the proximal end of the cut jejunum and the distal part of the jejunum are 30 cm away from the anastomosis of the gallbladder jejunum for end-to-side anastomosis. The transverse colon and jejunum mesenteric pores are sutured to prevent internal hemorrhoids.

The material in this site is intended to be of general informational use and is not intended to constitute medical advice, probable diagnosis, or recommended treatments.