It is unusual for growths involving the head of the pancreas to produce obstruction to both the common bile duct and the duodenum to such a degree that, if benefit is to be derived from an operation, it will be necessary to drain the stomach as well as the biliary passages. For this reason, I shall report the history of a patient suffering from such a growth, in whom symptomatic relief was obtained by combining cholecystogastrostomy with gastrojejunostomy. At the same time, I shall review briefly the histories of eight other patients operated on for the relief of chronic obstructive jaundice. If it is possible to establish suitable drainage sufficiently early in these cases, symptoms resulting from the obstruction will be relieved; but the final outcome will depend on the nature of the primary disease. Should chronic pancreatitis, or other nonmalignant condition, be the cause, a cure may result. Fortunately,
DOWNES WA. CHRONIC OBSTRUCTIVE JAUNDICE (NONCALCULOUS): REVIEW OF NINE CASES TREATED BY CHOLECYSTOGASTROSTOMY. JAMA. 1923;80(6):377–380. doi:10.1001/jama.1923.02640330013006
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