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A New Surgical Approach

George R. Wagner, MD; Edward Passaro, Jr., MD

AMA Arch Surg. 1971;103(1):21-24.

Abstract
Five cases of choledochoduodenal fistulas secondary to duodenal ulcer disease occurred. All patients had a surgical procedure for their duodenal ulcer disease, although the presence of a fistula in itself is not an indication for surgery. In three patients difficulty was encountered in closing the duodenal stump due to the presence of the fistula. A new procedure was utilized in two of these patients in which the opened duodenal stump was sutured to ulcer margins enclosing the fistula. Internal bile drainage was adequately maintained and duodenal stump blowout was avoided by this technique. No patient has had any evidence of postoperative ascending cholangitis.

Author Affiliations
Los Angeles

From the Surgical Service, Veterans Administration, Wadsworth General Hospital; and UCLA School of Medicine, Los Angeles.

Footnotes
Accepted for publication Feb 12, 1971.

Read before the annual meeting of the Southern California Chapter of the American College of Surgeons, Palm Springs, Calif, Jan 17, 1971.

Reprint requests to Veterans Administration, Wadsworth General Hospital, Wilshire and Sawtelle boulevards, Los Angeles 90073 (Dr. Passaro).

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