HEPATICOJEJUNOSTOMY AND HEPATOJEJUNOSTOMY

Abstract

A review of the literature on surgical problems of obstructive jaundice reveals that various methods have been unsuccessfully tried up to 1945, except for some case reports of successful management of biliary tract obstruction. But in recent years a number of cases have been successfully treated by intrahepatic drainage.
It is the purpose of this paper to dem onstrate a new operative method for only one group of extrahepatic biliary obstruction. The present reports refer to those patients with a persistent obstruction elsewhere high in the extrahepatic biliary tract. Intraductal drainage was obtained by inserting a free cut end of the jejunum into the unobstructed common hepatic duct and was successfully carried out in our first case.
While in Japan in order to reduce the jaundice of the patients with an extrahepatic biliary obstruction in the hepatic hilus region, Honjo, in 1953, attempted to divert the contents of the congested intrahepatic biliary system directly into the jejunum; it was performed to anastomose a resected small portion of the liver edge to the opening of the jejunum. This simple method was employed on our second case.