[Duodenal ulcer and a short common bile duct. Significance of duodenocholedochal reflux]

In connection with 8 cases of congenital short choledochus, associated with duodenal ulcers, of which 5 were diagnosed before surgery on the basis of duodeno-choledociab barium reflux, the authors review the data in the literature, confronted to their own experience. The frequency and the functional consequences are discussed, of the congenital short choledochus, the relationships of the papilla with the ulcerative lesion depending on the variants of the papilla, and the topography of the ulcers, the problems of diagnosis raised by the duodeno-biliary barium reflex, the preoperative complementary investigations, the intra-operative exploration, as well as the elements of operative tactics and techniques. The importance of intravenous cholangiography is stressed, on a routine basis in ulcerous patients, as well as the usefulness of intraoperative cholangiography in difficult cases of duodenal ulcers, that have a close relationship with them main biliary pathway. From the viewpoint of their surgical attitude and preferences the authors apparently prefer the exclusion resection of the ulcer, in association with troncular vagotomy.