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WE WISH to report 6 cases of complete stricture of the extrahepatic bile ducts in which external hepaticostomy was followed by the spontaneous development of a hepatoduodenal fistula. In 5 of these cases no effort was made to create an anatomic condition which would favor the development of such a fistula. A rubber catheter was sutured into the intrahepatic duct to create an external biliary fistula in the first 2 cases. It was the intention of the surgeon (W.W.) to transplant the fistulous tract into the intestine at a later date, but a fistula developed between the bile duct and the intestine in the interim. Owing to the gratifying result obtained in these cases, one of us (W.W.) decided to use a similar surgical procedure in the next case of complete stricture of the extrahepatic bile ducts in which an anastomosis could not be effected between a patent bile duct
WALTERS W, MARVIN CP. COMPLETE STRICTURE OF THE EXTRAHEPATIC BILE DUCTS: External Hepaticostomy Followed By Spontaneous Hepatoduodenal Fistula. Arch Surg. 1948;57(1):18–23. doi:https://doi.org/10.1001/archsurg.1948.01240020021003
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