The Effect of Dudenum-Decending Method on Biliary Duct Reoperation in Patients with Repeated Biliary Operation        LI Ke-zhou, LUO Zhu-lin, YAN Hong-tao, et al.PLA General Surgery Center, Chengdu Military General Hospital, Chengdu610083,China.
Corresponding author：LI Ke-zhou, E-mail：kzlchina@yahoo.com
Abstract    Objective    Here we introduce our expierance on searching biliary duct in some difficult condition in biliary reoperation. Methods    The data of 2457 cases with reoperation on biliary tract after repeated biliary operations over the past 10 years was analyzed. Duodenum-decending method was used in 31 cases when failed with conventional method. The duodenal bulb was freed and decended to expose the relatively normal posterior duodenal part of extra hepatical biliary duct, the duct was freed and incised upward to the hepatic porta,then accomplied with succeded operation manuver. Results    The cases operated with duodenum-drop method accounted for 1.16 percent (31/2457) of the patients during the same period. All the 31 cases were found extra hepatical duct successfully by this method, with operation time of 3~5mins (average 4.5 min), and blood loss of 1.5~2.0ml (average 1.8ml). There were no significant difference in abdominal drainage and gastrointestinal function recovery between duodenum-drop method group and conventional method group. Conclusion    Separating and finding the bile duct is sometimes very difficult in biliary reoperation. Duodenum-drop method is feasable and with high success rate,which can be used as a useful complement to other conventional methods.