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July 1924


Author Affiliations

From the Department of Surgery, Washington University School of Medicine.

Arch Surg. 1924;9(1):16-24. doi:10.1001/archsurg.1924.01120070019002

The surgeon confronted with a permanently blocked common bile duct and an available gallbladder hesitates to employ the present operation of cholecystogastrostomy or cholecystenterostomy on account of the probability of the ultimate development of liver infection. This result not only is shown in clinical experience, but can be demonstrated experimentally. Gatewood and Poppens,1 after extensive experimental production of cholecystogastrostomies, cholecystenterostomies and cholecystocolostomies in the dog, came to the following, among other, conclusions: "All livers become infected sooner or later if the method employed in our experiments be followed. Cholecystenterostomy, from an experimental standpoint, is not an operation to be recommended for use except in well-selected cases such as carcinoma of the pancreas, where the temporary comfort of the patient is paramount; or irreparable common duct obstruction." This paper furnishes an excellent general review of the subject from the clinical and experimental aspects.

The present study is an attempt to

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