ANASTOMOSIS OF THE OBSTRUCTED COMMON BILE DUCT TO THE INTESTINE

Abstract

ANASTOMOSIS of obstructed common bile duct to duodenum in dogs has previously been studied and reported.¹ Persisting wide patency of the anastomosis was obtained by mucosa-to-mucosa approximation of the duct to the intestine, but free reflux of intestinal content into the biliary tract occurred and was associated with marked cholecystitis and cholangitis. The experiments reported in the present study were primarily undertaken to assess the value of a long blind antiperistaltic (Roux-Y) loop of jejunum for biliary intestinal anastomosis, with the hope that ascending inflammation would be minimized. METHOD Mongrel dogs, divided into four groups, were used as experimental animals. The common bile duct was divided between distally placed ligatures at the initial operation. After an interval of two or three weeks the obstructed common bile duct was directly anastomosed to the duodenum in Group 1. In Group 2 a 12-in. (30 cm.) blind antiperistaltic limb of jejunum, utilizing