Gastric and Duodenal Infusion by Means of the Duodenal Tube

Abstract

Maury2 used a duodenostomy opening for this purpose in the experimental laboratory. Since Matas3 found it impossible, in some cases of cystic or of common duct obstruction, to instil fluids into the duodenum by the simple drip method through the biliary fistula, he passed a fine catheter through the biliary tract into the duodenum. It occurred to me that the passage of a catheter by mouth into the duodenum would be preferable to the biliary route, since it could be used in other than biliary fistula cases and would be more certain than the drip into the biliary drain. To the technic of a gastro-enterostomy or a stomach resection, McArthur4 has recently advocated adding the performance of a temporary biliary fistula made in the normal gallbladder. The use of the biliary route to the duodenum in cases in which a fistula would ordinarily be made, for the treatment of some pathologic condition of that tract, would not increase the dangers of infection, of permanent fistula, or of shock from prolonging the operation ; but a biliary fistula made for the purpose of duodenal infusion, in addition to some other operation, would decidedly increase those dangers, and would have a marked disadvantage over a method as simple in performance as