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Kenneth W. Starr, F.R.C.S.
AMA Arch Surg. 1953;66(4):398-399. doi:10.1001/archsurg.1953.01260030413002.
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IN 1938, Lahey suggested that gallstone surgery had evolved through the three stages of cholecystostomy, cholecystectomy, and choledochotomy. Now possibly it has entered a fourth stage, that of dealing with residual problems. External biliary drainage after choledochotomy by means of an indwelling tube (or T-tube) has had a wide vogue. In a recent study, however, I drew attention to the fact that tubal drainage is not always certain drainage and that obstructive jaundice and biliary peritonitis may still occur. Furthermore, the technical problem of an irremovable T-tube, or the fluid and electrolyte imbalance associated with excessive loss of bile may tax the most expert.

The results of a five-year study in 160 cases of drainage of the common bile duct were presented before the Mayo Foundation on Oct. 3, 1952. It indicated that external biliary drainage had occasionally failed to prevent recurrence of obstructive jaundice or to ameliorate with certainty


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