Summary
doi: 10.25005/2074-0581-2012-14-4-22-28
Advanced technique of hepatic-enteral stomy on disposable transhepatic drainage by Goetz in treatment of patients with «fresh» injuries and strictures of hepaticocholedochus
SBE Institution «Samara State Medical University»; MMBI «City Clinical Hospital №1 by NI Pirogov», Samara, Russia
The advanced technique of hepatic-enteral stomy on removable transhepatic drainage (THD) by Getz was studied in reseach. Surgery consists of three stages. The first stage - the reveal of damaged or stenotic biliary duct and prepare the site for anastomosis forming. The second stage – conduction of transhepatic drainage with help of proposed device - it is a bougie with a hole on the end for introduction of guide from PVC suture. The third stage - forming of hepatic-enteral anastomosis using meticulous absorbable suture and conducting of the second end of drainage through the loop of small intestine, defunctionalized by Rouh at a distance of 70 cm, and suspended enteral stoma.
This type of surgical technique – hepato-enterostomy with removable THD’s by Getz – was used in 41 patients. There were no any complications after surgery, which would require relaparotomy due to early failure of hepato-enterostomy. Replacement of transhepatic drainage was performed every two months, and removal - after two years. Stricture recurrence in the area of anastomosis after removal of drainage developed in only one (2.4%) patient.
Keywords: hepaticocholedochus, «fresh» injury, stricture , operation by Getz.
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