NUMEROUS contributions to the surgical literature have been made regarding anomalies of the extrahepatic biliary system, with emphasis on potential surgical errors during so-called routine cholecystectomy.* Certain of the variations pose at first as normal cases, since the anomalous part lies just out of the restricted range of the immediate field of operation at the neck of the gall bladder. These are understandably misleading to the operator whose practice it is to attack the first structure that appears to be a bile duct joining that which appears to be the common duct and the first blood vessel that happens to lie in the usual position of the cystic artery at the neck of the gall bladder. Thus, the true nature of a devious main biliary tract is sometimes discovered only after ligation and division of one of its essential limbs. It is the purpose of this paper to reemphasize the
NYGREN EJ, BARNES WA. ATRESIA OF THE COMMON HEPATIC DUCT WITH SHUNT VIA AN ACCESSORY DUCT: Report of a Case. AMA Arch Surg. 1954;68(3):337–343. doi:10.1001/archsurg.1954.01260050339009
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