17. OPERATIONS ON THE STOMACH, LIVER, GALLBLADDER, SPLEEN AND PANCREAS

Topics of the lesson. Surgical accesses to organs of abdominal cavity. Operations on the stomach: the technique of suture ligation of perforated stomach ulcer gastrostomy (by Witzel, Toprover, Kader), gastrointestinal anastomosis (types and technique). Gastrectomy by Bilrot-1 and Bilrot-2, their modern modifications. Methods of preparation of the duodenum stump. Post-resection syndromes. «Vicious circle» and his preventive. Pyloroplacty. Truncal and selective proximal vagotomy. Operations on the liver and cystic duct. Block of ligamentum teres hepatis. Liver?s suture. Fundamentals of the liver transplantation. Surgical treatment of portal hypertension. Cholecystectomy: types, technique. Cholecystostomy and choledochotomy. Splenectomy. Operations on pancreas: approaches, drainage of cysts and abscesses. Duodenopancreatectomy.

17.1. Write down the stages titles of the Witzel gastrostomy, use the Fig. 17.1.

Fig 17.1. Witzel gastrostomy 1. __

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2. __

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3. __

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4. __

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17.2. Which types of gastrostomy do you know?

1. __

2. __

3. __

17.3. Write down the names of gastroenteroanastomosis in the Fig. 17.2.

Fig. 17.2. Types of gastroenteroanastomosis

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2. __

3. __

4. __

17.4. Put down the methods of gastrectomy in the Fig. 17.3. Specify the differences from each other.

Fig. 17.3. Types of gastrectomy

17.5. What is the mobilization of the duodenum using Kocher's method?__

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In which type of gastrectomy this method is used? For what purpose?__

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Put the line of section of the peritoneum at this mobilization in the Fig. 17.4.

Fig. 17.4. The scheme of the duodenum mobilization by Kocher

17.6. What stage of the operation on creating the gastrointestinal anastomosis is presented in the Fig. 17.5?_