International Practices in Pancreatic Surgery by René Mantke Hans Lippert Markus W. Büchler & Michael G. Sarr

Author:René Mantke, Hans Lippert, Markus W. Büchler & Michael G. Sarr
Language: eng
Format: epub
Publisher: Springer Berlin Heidelberg, Berlin, Heidelberg

Fig. 12.3(a) The right gastroepiploic artery and vein are clamped, divided, and ligated with 2-0 silk. (b) Any retroduodenal arteries are clamped, divided and ligated with 3-0 silk mobilizing approximately 3 cm of duodenum beyond the pylorus (Reproduced with Permission of Mayo Foundation for Medical Education and Research. All Rights Reserved)

Fig. 12.4(a) Attention is directed to the infracolic compartment. The ligament of Treitz is taken down being careful to protect the inferior mesenteric vein. (b) After the jejunum is transilluminated, an appropriate arcade chosen for dividing the mesentery of the jejunum approximately 20 cm beyond the ligament of Treitz. The jejunal mesentery is clamped, divided and ligated with 3-0 silk. (c) The bowel is transected with a GIA stapler. The jejunal/duodenal vessels are ligated in continuity with 3-0 silk and divided. Alternatively, a LigaSure® device may be used for this step. (d) Dissection is carried proximal until the uncinate process is visible (Reproduced with Permission of Mayo Foundation for Medical Education and Research. All Rights Reserved)

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