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Surgery of the extrahepatic biliary tree constitutes a significant proportion of the work of the general surgeon. In addition, many practitioners who would ordinarily not attempt "major" operative surgery, consider cholecystectomy fair game. As the editors of this text point out, there are three ways in which poor results from biliary tract operations may be incurred: (1) The operation should not have been performed in the first place, eg, when it is done for symptoms actually arising from another cause. (2) The operation may be inadequately performed, eg, when calculus material is left residual in the common duct. (3) The operation is improperly performed, eg, when damage to the right hepatic artery or the common duct is sustained. Because of the apparent simplicity but actual complexity of the extrahepatic biliary tree, there are few areas of the abdomen in which the challenge to the surgeon's imagination and technical skill is
Eisenberg MM. Surgery of the Gall Bladder and Bile Ducts. JAMA. 1965;193(1):80. doi:10.1001/jama.1965.03090010086036
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