EFFECT OF DIRECT ANASTOMOSIS OF COMMON BILE DUCT TO DUODENUM

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Abstract
DIRECT choledochoduodenostomy is not infrequently performed in patients who require common duct reconstruction, especially in those instances when the distal end of the common duct cannot be found. Although some regurgitation of the duodenal content into the biliary system is bound to occur after such an operation, the effect of this reflux may or may not be important, depending upon the degree of ascending cholangitis that develops. The experiment to be reported in this paper was undertaken in an attempt to determine the incidence and severity of ascending infection following elimination of the sphincter of Oddi from the extrahepatic biliary system. METHOD Mongrel dogs were used as experimental animals. At a preliminary operation the common bile duct was doubly ligated and cut across close to the duodenum (Fig. 1). One to three weeks later the abdomen was again opened, and the greatly dilated common bile duct (often the diameter of

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