Chronic relapsing pancreatitis has proved a challenge to both the internist and the surgeon, and because of an inability to control the natural course of the disease by conservative medical therapy it has become a surgical problem. A common etiological factor for all cases of pancreatitis has not been generally accepted. The relief of symptoms by biliary diversion operations, such as choledochojejunostomy en Roux Y as described by Bowers and Greenfield,* and elimination of sphincter of Oddi obstruction by sphincterotomy, as described by Mulholland and Doubilet,† suggests that a common pathway for drainage of both biliary and pancreatic secretions with obstruction at the sphincter of Oddi and resultant biliary regurgitation into the pancreas is a frequently encountered cause of chronic relapsing pancreatitis.
Choledochojejunostomy en Roux Y7 is accomplished by a primary division of the jejunum 10 to 12 in. below Treitz's ligament, with a distal implantation of the proximal
KEHNE JH, CAMPBELL RE. Choledochojejunostomy en Roux YAn Experimental Study. AMA Arch Surg. 1956;73(1):12-18. doi:10.1001/archsurg.1956.01280010014003