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February 11, 1983

Surgery promising in sclerosing cholangitis

JAMA. 1983;249(6):695. doi:10.1001/jama.1983.03330300011006

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Like many physicians who treat liver disease, surgeon John L. Cameron, MD, and internist Willis C. Maddrey, MD, have long been concerned with the lack of specific therapy for patients with sclerosing cholangitis. Multiple strictures and small fibrotic ducts characterize this chronic inflammatory disease and have complicated attempts to treat it by surgery.

Then, three years ago, while reviewing cholangiograms of patients who had come to Johns Hopkins University School of Medicine in Baltimore for treatment of the condition, the two investigators noted that often the most narrowed area was at the bifurcation of the hepatic duct.

They began to work on a surgical strategy, preliminary results of which were reported at the meeting of the American Association for the Study of Liver Diseases (of which Maddrey is president) in Chicago. The strategy involves resecting the hepatic duct bifurcation, gently stretching the left and right hepatic ducts with a metal