ARCHIBALD discovered that transduodenal section of the sphincter of Oddi for the removal of a stone impacted in the ampulla of Vater caused improvement in coexisting chronic pancreatitis. This led Doubilet and Mulholland to undertake sphincterotomy as a method of treatment of pancreatitis. Palliative bypass of cancer of the head of the pancreas, done for many years by anastomosis of the gall bladder to the stomach, duodenum, or jejunum, produced 15% five-year survivals in cases which Walters1 said must be assumed to have been inflammatory. The present paper advocates such a bypass by means of a Roux-Y segment of jejunum as definitive treatment for chronic recurring pancreatitis.
Since the original work of Opie2 in 1901, there have been many champions of the theory that pancreatitis is produced by a reflux of bile into the pancreatic duct as a result of a stone impacted in the ampulla of Vater.