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

V.I. Belokonev, Khunkuy I, Z.V. Kovaleva, A.V. Nikolaev, A.I. Salem

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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