There is, at present, a general uncertainty about the satisfactory outcome of repair of the common bile duct. One may classify restoration of the bile passages into: (1) end to end suture of the ducts, (2) implantation of the bile ducts into the duodenum or stomach, (3) bridging a gap by a rubber tube or by foreign tissue grafts and (4) repair by pedunculated flaps from the stomach, duodenum, jejunum, gallbladder or skin.
End to end suture of a dilated part of the common duct over a buried rubber tube was performed by Doyen,1 in 1892, following the removal of a large stone. Death resulted from hepatic insufficiency. Kehr2 found it advisable to bring a rubber T tube out through the union for drainage. Jacobson3 stated that complete closure of the duct at the suture line was undesirable, and he observed secondary stenosis in a number of cases at reoperation.
McWHORTER GL. NEW METHODS OF ANASTOMOSIS OF THE COMMON BILE DUCT: AN EXPERIMENTAL STUDY. Arch Surg. 1929;18(1_PART_I):117–128. doi:10.1001/archsurg.1929.04420010119005
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