0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
ARTICLE |

External Bypass Operation for Biliary Tract Obstruction

ROBERTO BLANCO-BENAVIDES, MD
Arch Surg. 1981;116(6):841. doi:10.1001/archsurg.1981.01380180085018.
Text Size: A A A
Published online

To the Editor.—Biliary obstruction secondary to nonresectable malignancy or inflammatory and iatrogenic stricture of the biliary tract is a serious condition. Decompression is essential to relieve obstruction, to allay symptoms, and to prolong life. Many procedures for decompression of the biliary tract have been reported, including bypass operations,1 percutaneous transhepatic drainage,2,3 and internal prostheses.4

I and my colleagues have been using an external biliary bypass that decompresses the biliary tree, bypasses the obstruction, and is easy to perform. At the time of laparotomy, a portion of the dilated biliary tract is exposed and opened proximal to the obstruction. A T-tube is inserted, with the long stem of the T-tube drawn to the exterior through a small stab wound. Similarly, the common duct, duodenum, or jejunum distal to the obstruction is selected and a T-tube is inserted. As with the proximal tube, the long vertical stem of

Topics

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

First Page Preview

View Large
First page PDF preview

First Page Preview

View Large
First page PDF preview

Figures

Tables

References

Correspondence

CME
Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Submit a Comment

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

Related Content

Customize your page view by dragging & repositioning the boxes below.

Jobs
brightcove.createExperiences();