By-pass anastomosis of intrahepatic duct to the gallbladder

Obstruction of the extrahepatic bile ducts by primary or metastatic carcinoma can sometimes be diffiult to relieve. Frequently there is an inadequate length of normal duct proximal to the obstruction to permit an anastomosis. A by-pass anastomosis between a dilated right hepatic biliary radicle and the gallbladder is a simple and satisfactory method of relieving the jaundice. This can be accomplished by using a T-tube as a stent; a vein graft over the T-tube limb in the liver seems to improve the result.