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July 1956


Author Affiliations

From the Surgical Service, Veterans Administration Medical Teaching Group Hospital, Memphis.

AMA Arch Surg. 1956;73(1):18-20. doi:10.1001/archsurg.1956.01280010020004

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ONE OF the two distinct disadvantages to the operation choledochojejunostomy en Roux Y is the possibility of formation of peptic ulcer which may arise when the duodenum is denied one of the neutralizers in the form of bile, which, of course, is shunted away from the duodenum into the distant defunctionalized jejunum. The other disadvantage involves transection of the common duct, a maneuver which no knowing surgeon wishes to negotiate. Experiences with the operation do not substantiate the fear of cutting the duct because postoperative incidents, such as stricture, cholangitis or nonulcer physiological disturbances, have not been great enough in number to be significant. Moreover, most students of the disease known as recurring or relapsing pancreatitis agree that the ravages of the disease are so terrifying that some risk and well-studied use of radical procedures are justified if the disease can be controlled by these measures. Successful control can be

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