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TREATMENT OF BILIARY DYSKINESIA WITH SPECIAL REFERENCE TO SPHINCTEROTOMY

LOUIS J. LESTER, M.D.; RALPH COLP, M.D.
AMA Arch Surg. 1952;64(2):168-174. doi:10.1001/archsurg.1952.01260010180006.
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BILIARY dyskinesia is an elusive entity which is frequently overlooked as a cause for clinical symptomatology. The phrase means literally "a disturbance in the normal kinetics of bile flow." This disturbance can better be appreciated if the factors affecting normal bile flow are understood. The physiology of biliary dynamics is fairly well established. Bile secretion, which is a continuous process, is constantly being poured into the canaliculi of the liver.1 The flow of bile depends on the vis a tergo of its secretory pressure (60 to 70 mm. of water) and is modified by the resistance offered by the sphincters in the biliary tract. These are located in the cystic duct, in the neck of the gall bladder and possibly in the hepatic duct.2 Their presence is variable, and their function is uncertain, but they do not alter biliary dynamics materially. The important regulating mechanism of bile flow

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