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May 1961

Bile Duct Reconstruction with a Gastric Pedicle Tube: An Operation for Restoring Continuity Between the Biliary Passages and the Gastrointestinal Tract

Author Affiliations

From the Surgical Division, Montefiore Hospital, New York City.; Adjunct Thoracic Surgeon, Montefiore Hospital, and Assistant Clinical Professor of Surgery, New York Medical College (Dr. Heimlich); Assistant Resident in Surgery, Montefiore Hospital (Dr. Gitlitz).

Arch Surg. 1961;82(5):755-763. doi:10.1001/archsurg.1961.01300110117015

Introduction  The treatment of benign or malignant obstruction of the bile ducts has been generally unsatisfactory. Attempts at restoring the flow of bile from the hepatic ducts to the gastrointestinal tract frequently end in failure owing to the development of strictures or the reflux of gastrointestinal contents into the biliary tree. When either of these complications occurs, the patient develops chills, fever, and jaundice as a result of recurrent biliary obstruction or ascending cholangitis. An additional operation must then be performed in order to prevent the death of the patient.When the common bile duct is obstructed by carcinoma of the head of the pancreas, a common method of bypassing the obstruction has been to anastomose the gallbladder to the stomach. The gastric mucosa is not adversely affected by the presence of bile, and the bile ducts appear to tolerate the proximity of gastric mucosa, provided that reflux of gastrointestinal