THE SURGICAL correction of benign stricture of the common bile duct is one of the most technically challenging surgical problems. As emphasized by Cattell1 and others, the best long-term results ensue when the ampulla of Vater's normal function is preserved. In the clinical setting, however, this is frequently not possible. The only recourse then is to implant the proximal duct into an adjacent portion of jejunum or duodenum.
Considerable effort has been expended in the search for a suitable substitute for biliary ductal structures. Imaginative attempts using metal, rubber, and plastics2-5 have uniformly been unsuccessful. Viable structures of all sorts have been tried. These have included autogenous vein, artery, appendix, fascia, peritoneum, jejunum, and skin,6-10 as well as homografts of preserved common bile duct and artery.10 None of these tissues so used has met with success in a significant percentage of cases. Failures in graft substitution
LINDENAUER SM, CHILD CG. Vascularized Venous Autografts in Common Bile Duct Reconstruction. Arch Surg. 1966;92(5):749-751. doi:10.1001/archsurg.1966.01320230097018