Biliary and Hepatic Factors in Peptic Ulcers

Duodenal Ulceration after Diversion of Bile

“…Direct diversion of bile to the outside, as was shown by other investigators, had the same effect [Berg and Jobling, 1930], In striking contrast to the ample attention this topic has received in the experimental surgical literature, only a few documented reports on the clinical occurrence of this intriguing complication of bile diversion have been available thus far [A ust et al, 1967;Bow ers, 1964; C o u in a u d and Bronstein, 1970;O 'M alley et al, 1951]. Recently, the matter received renewed interest in a clinical study [M c A r t h u r and L o n g m ire, 1971], in which the duodenal ulcer incidence was studied in a relatively large series of patients who had undergone a choledocho-jejunostomy for benign common duct obstruction, as compared to the ulcer incidence in a group of patients treated with a choledocho-duodenostomy.…”