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December 11, 1926


JAMA. 1926;87(24):2001-2002. doi:10.1001/jama.1926.02680240045020

The questions of cholecystectomy versus cholecystostomy and of both versus nonsurgical drainage of the gallbladder 1 have been held in abeyance by conservative thinkers pending the interpretation of recently acquired knowledge of biliary physiology and pathology. Wilke 2 has recently harmonized some of this new knowledge with the conditions personally found in the operating room. The gallbladder with stasis, in a large proportion of cases, is the result either of hypertonia or hypotonia. Understanding of the mechanism concerned requires a knowledge of the anatomy and physiology of the biliary tract. Elsewhere in this issue 3 it is shown that the gallbladder is not a passive organ and that its wall contains an abundance of smooth muscle. Another muscular structure of importance is the sphincter of Oddi, which surrounds the outlet of the common duct at the point where it joins with the pancreatic duct to form the papilla of Vater.