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Article
October 12, 1918

RECONSTRUCTION OF THE COMMON BILE DUCT

Author Affiliations

RICHMOND, VA.

JAMA. 1918;71(15):1188-1194. doi:10.1001/jama.1918.02600410010003
Abstract

Defects in the common bile duct may result from errors in operative technic, from strictures following ulceration or trauma, or from neoplasms. Since excision of the gallbladder has become a frequent practice, possibilities for injuring the common bile duct, particularly in inexperienced hands, have multiplied.

In an effort to devise some method that would be satisfactory in reconstructing the common duct, various procedures have been devised. Sullivan1 described an operation in which a rubber tube is sutured into the stump of the hepatic or the remaining upper end of the common duct, carried into the duodenum, and surrounded with neighboring tissue and omentum. Molineus, according to Walton, has suggested the use of the appendix for reconstruction of the common duct. However, it is often difficult to secure a satisfactory appendix, the nutrition of the transplanted appendix would be very problematic, and it would carry bacteria it normally contains, which

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