[Surgical rehabilitation of nonfunctioning bilio-digestive shunts]

The authors consider the internal biliary derivations as a choice procedure for the resolution of various pathological conditions of the biliary pathways and of the pancreas. They are based on the experience accumulated in the course of a total of 416 derivations performed in the last 10 years. The confrontation with particular problems raised by 40 re-interventions for failure of internal biliary derivations has determined an analysis of causes, clinical manifestations and possibilities to solve the disturbances. Categories are discussed, in which these patients can be classified and clinical observations are presented, in connection with the etiopathogeny of the non-functioning of the derivations. Possibilities are also presented for the resolution of the problems in each particular case. Two technical possibilities are presented for the correction of non-functioning biliary-digestive anastomoses, by performing bilio-biliary anastomoses.