Word: duodenum
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Nature designed the ducts to carry bile on its way from the liver, where it is made, to the duodenum, where it aids in digestion. Among the estimated 200 occurrences each year of biliary atresia in the U.S., there are a few in which ducts outside the liver are large enough for corrective surgery. But not in William's case...
...trained his surgical microscope, working at 20-to 40-power magnification, on the minuscule bile ducts. He exposed them, and with incredibly fine needlework sewed one branch of the U over them like a funnel. He sutured the other branch of the U into the upper part of the duodenum, about where nature intended bile...
Almost all nutrients enter the system by absorption through the walls of the small intestine, which had been removed and replaced by an emergency short circuit from the patient's duodenum to the remainder of her colon (see diagram). The only recourse was intravenous feeding, which is rarely satisfactory for more than a few weeks, even in a hospital. And Jane Smith (not her real name), 37, was eager to go home to her two young children...
There was also the problem of the bile ducts. The donor liver had come with its gall bladder and ducts attached. Rather than attempt a dangerously delicate joining of the common duct to the duodenum, Moore decided to attach the new gall bladder itself to the duodenum, allowing the bile to bypass the common duct. The entire operation took eight hours. Not until Tommy Gorence was sitting up and eating well, apparently making a good recovery, did the Brigham publicize the case. Tommy made good progress for four weeks, then ran into difficulties with a lung infection, a common complication...
...Paulo transplant, Rio de Janeiro's Dr. Edson Teixeira implanted a pancreas in diabetic, ex-soccer-star -turned -government-official Arari Charbel Rios, 28. Rather than remove Rios' failing pancreas, Teixeira simply stitched the new organ, donated by a heart-attack victim, to his patient's duodenum-snugly against the old one. At the first sign of rejection, says Teixeira, he will simply snip the implant out and Rios will be back where he started-on insulin...