Defunctionalized jejunal limb for long-term access to the biliary tree.

The morbidity associated with repeated operations for recurrent biliary disease is well recognized. It has been postulated that symptomatic relief could be provided nonoperatively using radiologic and endoscopic techniques via a defunctionalized jejunal limb brought out to the subcutaneous space at the time of choledochojejunostomy, and later reached by local cutdown. We have described the nonoperative management of multiple intrahepatic and common bile duct stones successfully removed via such a defunctionalized jejunal limb. Our results suggest that this technique can effectively allow nonoperative access to the biliary tree for treatment of recurrent biliary disease.