Intrahepatic Cholangiojejunostomy (Longmire Procedure) in Carcinoma of Intrahepatic Bile Ducts

A recent report¹has emphasized the small number of cases of intrahepatic cholangiojejunostomy recorded since Longmire and Sanford²introduced this procedure in 1948. Its authors have summarized 28 cases, 19 procedures having been carried out for benign obstruction and 9 for malignant obstruction. We wish to report an additional instance of the use of this operation. At first a benign process was thought to be obliterating the common bile duct, but at autopsy, 11½ months later, primary adenocarcinoma of the intrahepatic bile ducts was shown to be the cause of obstruction. The operation completely relieved the jaundice. The cause of death was hemorrhage from esophageal varices. Report of a Case A 64-year-old widow was admitted to the hospital Jan. 3, 1954, because of intermittent distress in the upper part of the abdomen for 20 years. There was evidence of cholelithiasis. There was no jaundice. On Jan. 8 a