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SURGICAL ANATOMY OF THE CHOLEDOCHAL NERVES

SURGICAL ANATOMY OF THE CHOLEDOCHAL NERVES Abstract THE ANATOMY of the nerves of the biliary system has aroused surgical interest because of its potential importance in connection with the pain syndrome occurring after cholecystectomy and during biliary dyskinesia. Womack and Crider1 have successfully treated patients with persistent symptoms of biliary disease following cholecystectomy by section of the choledochal nerves in the region of the cystic duct remnant. Denervation of the ductus choledochus has been proposed as a method of treatment for biliary dyssynergia, but the operation has been attempted by relatively few surgeons.2 Differences in the operative descriptions of biliary denervation, variations in the accounts of the anatomy of the biliary nerves and the scantiness of the available literature on this subject have made it desirable to restudy the nerves of the choledochus. Although the nerves of the biliary system have been studied by many anatomists, emphasis has been placed mainly on the topography of References 1. Womack, N. A., and Crider, R. L.: The Persistence of Symptoms Following Cholecystectomy , Ann. Surg. 126:31, 1947.Crossref 2. (a) Reich, H.: Choledochal Denervation , Surg., Gynec. & Obst. 71:39, 1940. 3. (b) Lagerlöf, H.: Choledochal Denervation in Biliary Dyskinesia , Acta chir. Scandinav. 95:297, 1947. 4. Cruveilhier, J.: Anatomie pathologique du corps humain, or descriptions avec figures lithographiées et colloriées, des diverses altérations morbides dont le corps humain est susceptible , Paris, J.-B. Baillière, 1837, vol. 3. 5. Luschka, B., 1863 6. Raigorodsky, J. L.: Ztschr. f. Anat. u. Entwcklngsgesch. 86:698, 1929. 7. Latarjet, A.: Bonnet, P., and Bonniot, A.: Les nerfs du foie et des voies biliares , Lyon chir. 17:1, 1920. 8. Schwalbe, G. A.: Lehrbuch der Neurologie , Erlangen, E. Besold, 1881. 9. Jayle, G. E.: Les nerfs du foie , Nutrition 7:57, 1937. 10. Raigorodsky, J. L.: Die Nerven der Leberpforte des Menschen , Ztschr. f. Anat. u. Entwckingsgesch 86:698, 1929. 11. Rio-Branco, P.: Essai sur l'anatomie et la médicine opératoire du tronc coeliaque et de ses branches de l'artère hépatique en particulier, Thesis, Paris, no. 168, 1912. 12. Kiss, F., and Ballon, H. C.: Celiac Plexus and its Branches , Arch. Surg. 19:399 ( (Sept.) ) 1929. 13. Alexander, W. F.: The Innervation of the Biliary System , J. Comp. Neurol. 72:357, 1940. 14. Perman, E.: Kirurgisk behandling av gallvägsdyskinesi , Nord. med. 22:701, 1944. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

SURGICAL ANATOMY OF THE CHOLEDOCHAL NERVES

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Publisher
American Medical Association
Copyright
Copyright © 1950 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1950.01250010967009
Publisher site
See Article on Publisher Site

Abstract

Abstract THE ANATOMY of the nerves of the biliary system has aroused surgical interest because of its potential importance in connection with the pain syndrome occurring after cholecystectomy and during biliary dyskinesia. Womack and Crider1 have successfully treated patients with persistent symptoms of biliary disease following cholecystectomy by section of the choledochal nerves in the region of the cystic duct remnant. Denervation of the ductus choledochus has been proposed as a method of treatment for biliary dyssynergia, but the operation has been attempted by relatively few surgeons.2 Differences in the operative descriptions of biliary denervation, variations in the accounts of the anatomy of the biliary nerves and the scantiness of the available literature on this subject have made it desirable to restudy the nerves of the choledochus. Although the nerves of the biliary system have been studied by many anatomists, emphasis has been placed mainly on the topography of References 1. Womack, N. A., and Crider, R. L.: The Persistence of Symptoms Following Cholecystectomy , Ann. Surg. 126:31, 1947.Crossref 2. (a) Reich, H.: Choledochal Denervation , Surg., Gynec. & Obst. 71:39, 1940. 3. (b) Lagerlöf, H.: Choledochal Denervation in Biliary Dyskinesia , Acta chir. Scandinav. 95:297, 1947. 4. Cruveilhier, J.: Anatomie pathologique du corps humain, or descriptions avec figures lithographiées et colloriées, des diverses altérations morbides dont le corps humain est susceptible , Paris, J.-B. Baillière, 1837, vol. 3. 5. Luschka, B., 1863 6. Raigorodsky, J. L.: Ztschr. f. Anat. u. Entwcklngsgesch. 86:698, 1929. 7. Latarjet, A.: Bonnet, P., and Bonniot, A.: Les nerfs du foie et des voies biliares , Lyon chir. 17:1, 1920. 8. Schwalbe, G. A.: Lehrbuch der Neurologie , Erlangen, E. Besold, 1881. 9. Jayle, G. E.: Les nerfs du foie , Nutrition 7:57, 1937. 10. Raigorodsky, J. L.: Die Nerven der Leberpforte des Menschen , Ztschr. f. Anat. u. Entwckingsgesch 86:698, 1929. 11. Rio-Branco, P.: Essai sur l'anatomie et la médicine opératoire du tronc coeliaque et de ses branches de l'artère hépatique en particulier, Thesis, Paris, no. 168, 1912. 12. Kiss, F., and Ballon, H. C.: Celiac Plexus and its Branches , Arch. Surg. 19:399 ( (Sept.) ) 1929. 13. Alexander, W. F.: The Innervation of the Biliary System , J. Comp. Neurol. 72:357, 1940. 14. Perman, E.: Kirurgisk behandling av gallvägsdyskinesi , Nord. med. 22:701, 1944.

Journal

Archives of SurgeryAmerican Medical Association

Published: May 1, 1950

References