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[A modification of the classic supraduodenal side-to-side choledochoduodenal anastomosis]
Abstract:
The authors subscribe to the standpoint that a "bile path" passes in biliodigestive anastomoses along the latero-posterior surface of the right hemi-circumference of the hepato-choledochus in the area where the choledocho-digestive anastomoses are constructed. A declivage (to this "bile path" in the hepato-choledochus) supraduodenal latero-lateral choledocho-duodeno-anastomosis is suggested. It is realized through latero-posterior choledochotomy and by oblique section of the duodenum in close proximity to its external edge. The stitches of the common bile duct needle are 2-2.5 mm apart from each other and from the end of the choledochotomy orifice and those of the--3-3.5 mm apart from each other and 6-7 mm from the end of the duodenotomy orifice. The sutures pass totally through the wall of the common bile duct and serous-muscular-submucosally (mucose-muscular-seriously) thorough the duodenal wall.