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Internal drainage of the biliary tract such as choledocho-duodenostomyand Roux-en-y choledocho-jejunostomy is a common operation for the treatment ofprimary choledocholithiasis and biliary strictrue.Though these procedures cancreat a good drainage,serious reflux cholangitis is frequently resulted.In orderto prevent this tiresome complication,the authors have designed a new procedure:a loop of jejunum is isolated;an artificial papilla is made on its distal end;thenits proximal end is connected to the bile duct and its distal end with the artificialpapilla is inserted into the duodenum;finally the isolated jejunal loop and theduodenum are sutured up.This paper is to report our experience of applying this procedure on 15 casesin the period from Nov.1982 to Nov.1985.After operation,no reflux of theintestinal contents into the interposed jejunal loop was found and barium mealwas able to demonstrate the reflux of the contrast medium only in one case out ofthe 15.14 cases have been followed up for 6-36 months and excellent results werefound.It proves that this operative procedure can prevent the reflux of chyme intothe biliary tract.In addition,interposed jejunal loop with an artificial papilla ismore physiological than Roux-en-y choledocho-jejunostomy since bile can flowthrough the interposed jejunal loop into duodenum to mix with the pancreaticfluid and chyme,which is helpful to better disgestion.
Internal drainage of the biliary tract such as choledocho-duodenostomy and Roux-en-y choledocho-jejunostomy is a common operation for the treatment of primary choledocholithiasis and biliary strictrue.Though these procedures cancreat a good drainage, serious reflux cholangitis is just caused.In orderto prevent this tiresome complication, the authors have designed a new procedure: a loop of jejunum is isolated; an artificial papilla is made on its distal end; thenits proximal end is connected to the bile duct and its distal end with the artificialpapilla is inserted into the duodenum ; finally the isolated jejunal loop and the duodenum are sutured up. This paper is to report our experience of applying this procedure on 15 cases in the period from Nov. 1982 to Nov. 1985. After operation, no reflux of the intestinal contents into the interposed jejunal loop was found and barium mealwas able to demonstrate the reflux of the contrast medium only in one case out of the 15.14 cases have been followed u p for 6-36 months and excellent results were found. It proves that this operative procedure can prevent the reflux of chyme intothe biliary tract. In addition, interposed jejunal loop with an artificial papilla ismore physiological than Roux-en-y choledocho-jejunostomy since bile can flowthrough the interposed jejunal loop into duodenum to mix with the pancreaticfluid and chyme, which is helpful to better disgestion.