STRICTURES of the bile ducts remain a serious surgical problem. Despite the numerous reconstructive procedures that have been tried,1 many patients eventually succumb with recurrence of the stricture, repeated attacks of cholangiohepatitis and progressive damage to the liver.
End to end suture of the divided ends of the bile ducts, if performed without undue tension, has given the best results. Unfortunately this procedure is not always possible, particularly when long segments of the ducts have been destroyed or when the defect extends into the hilus of the liver. By mobilizing the duodenum and, when necessary, splitting the head of the pancreas for identification of the distal duct, Lahey2 and Cattell3 have extended the scope of primary anastomosis of the duct ends. When this method is not feasible, one must choose between preserving the sphincter of Oddi by bridging the defect and by-passing the sphincter of Oddi by
KIRBY CK, FITTS WT. RECONSTRUCTION OF THE BILE DUCTS WITH AN ISOLATED SEGMENT OF JEJUNUMAn Experimental Study. Arch Surg. 1950;61(3):462-468. doi:10.1001/archsurg.1950.01250020467006