Abstract
Collection of bile from experimental animals has always presented almost insuperable difficulties. Simple intubation of the ducts or the gall bladder has resulted in ascending infection, which has seriously interfered with the results obtained, as the bile then originated in livers more or less damaged by hepatitis. In such preparations leakage and consequent loss of part of the bile nearly always occurs if the experiment is long continued. The Rous 1 type of fistula, in which a long tube is coiled within the abdomen thus putting considerable distance between the bile duct and the skin, has been used extensively in this laboratory with indifferent results. For a few weeks it was often successful, but a very high percentage of cases failed in later months which are the crucial point in these studies.
Dragstedt 2 recently reported a new type of fistula which he had used extensively for intestinal studies and for short periods in the gall bladder. It consisted in a gold-plated metal cannula, with a metal disc at the inner end. This was sutured into the intestine. The distal end was then capped with a special small spear point which was pushed through the abdominal wall at a little distance from the laparotomy wound. The intervening space (2-4 inches) was then wrapped in omentum. A screw cap at the distal end enabled one to attach a container.
This principle applied to the gall bladder has functioned with remarkable perfection. The cannula must be considerably longer than that used for intestinal work, as the liver moves on respiration. The total length of our cannulas was 5½ inches. The disc at the inner end was made smaller (¾ inch) and somewhat cup-shaped. After the common duct has been ligated, the cannula is simply implanted into the gallbladder through as small a hole as possible and tied in place. Inversion is not necessary, and not advisable.
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