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January 1961

Strictures of the Bile Ducts: Etiology, Prevention, and Management

Author Affiliations

From the Department of Surgery, University of Tennessee, Memphis, the City of Memphis Hospitals and the Baptist Memorial Hospital.

Arch Surg. 1961;82(1):171-174. doi:10.1001/archsurg.1961.01300070175022

Stricture of the common bile duct is generally considered to be one of the most serious lesions encountered by the general surgeon. The successful management of such lesions requires a degree of surgical judgment, technical skill, and ingenuity which is greater than that necessary for the successful management of many intra-abdominal conditions. Because of the serious nature of such strictures, all surgeons should be acquainted with the cause, prevention, and methods of correction of this condition.

Pancreatitis, penetrating postbulbar ulcer, congenital narrowing of the duct, erosion by stone, choledochal cyst, and similar conditions (excluding fibrosis of the sphincter of Oddi) probably account for less than 10% of all benign bile duct strictures. The great majority of bile duct strictures follow biliary surgery.

Anatomic variability and anomalies of the ducts and vessels in the right upper quadrant make cholecystectomy a potentially hazardous procedure. Inadequate exposure, failure to visualize all important structures,

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