There is, at present, a general uncertainty about the satisfactory outcome of repair of the common bile duct. One may classify restoration of the bile passages into: (1) end to end suture of the ducts, (2) implantation of the bile ducts into the duodenum or stomach, (3) bridging a gap by a rubber tube or by foreign tissue grafts and (4) repair by pedunculated flaps from the stomach, duodenum, jejunum, gallbladder or skin.
End to end suture of a dilated part of the common duct over a buried rubber tube was performed by Doyen,1 in 1892, following the removal of a large stone. Death resulted from hepatic insufficiency. Kehr2 found it advisable to bring a rubber T tube out through the union for drainage. Jacobson3 stated that complete closure of the duct at the suture line was undesirable, and he observed secondary stenosis in a number of cases at reoperation.