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Article
April 1955

Extrahepatic Biliary Duct Obstruction Due to StrictureChanges in Morphology and Physiology of the Liver and an Attempt at Prognosis

Author Affiliations

St. Louis
From the Department of Surgery, Washington University School of Medicine and Barnes Hospital.

AMA Arch Surg. 1955;70(4):519-529. doi:10.1001/archsurg.1955.01270100045008
Abstract

The purpose of this paper is to review the experimental and clinical facts pertinent to obstruction of the external bile ducts, with special reference to strictures, and to present the clinical, laboratory, and pathologic features of a collected group of cases in an attempt to formulate some basis for prognosis and treatment.

PREVIOUS WORK  How soon do clinical signs of extrahepatic obstruction appear in the experimental animal? In dogs, bile appears in the urine in 24 to 28 hours; scleral staining in 5 to 10 days, and generalized tissue icterus in 9 to 26 days after division and ligation of the common bile duct with the gall bladder intact.1 General signs of illness appear in the dog as anorexia and apathy at four weeks. As early as two days, there is an abrupt rise in total cholesterol and esters which is maintained for four to six weeks and then

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