• DOI:10.1046/j.1445-2197.2003.t01-1-02625.x
• Corpus ID: 21569199

Anthony Eden's bile duct: portrait of an ailing leader

@article{Kune2003AnthonyEB,
  title={Anthony Eden's bile duct: portrait of an ailing leader},
  author={Gabriel A. Kune},
  journal={ANZ Journal of Surgery},
  year={2003},
  volume={73}
}

• G. Kune
• Published 1 May 2003
• History
• ANZ Journal of Surgery

This biographical sketch of Anthony Eden was assembled from four biographies of Eden, his own memoirs, historical chronicles and from personal communications. 1–7 Eden was born in 1897. Both sides of his family were from the English ruling class. He was educated at Eton and Christ Church, Oxford. He won the Military Cross in 1917 for bravery during active service in World War I. In 1923, he married Beatrice Beckett, the daughter of a staunch conservative, Sir Gervase Beckett Bt. In the same year he was elected to the House of Commons in a safe Tory seat, which he held until 1957 when he retired from politics. In 1935 he became Foreign Secretary, but resigned in 1938 because he apparently believed that Prime Minister Neville Chamberlain’s attempts to appease fascist Italy and Nazi Germany were dangerous. Between 1940 and 1945 he was Foreign Secretary in Winston Churchill’s government. In February 1945, Eden and Churchill attended a conference in Yalta in the Crimea, where Stalin and Roosevelt in effect carved up Europe without significantly consulting Churchill. The decisions made there were much to the displeasure of both Churchill and Eden, who believed that Roosevelt was appeasing Stalin far too much, and that he was not sufficiently concerned about the future welfare of Europe. Indeed, it was subsequently revealed that at the Yalta Meeting, Roosevelt was quite ill and possibly not entirely comprehending the gravity and consequences of the decisions made. He died soon after this meeting. In April 1945, Anthony Eden attended the San Francisco Conference in which he strongly supported the establishment of the United Nations. Between 1945 and 1951 he was the Deputy Leader of the Opposition, and when the Tories regained power in 1951, he once again became Foreign Secretary in the new Churchill Government. In 1950 Eden’s first marriage was dissolved, and in 1952, at the age of 55, he married the 32-year-old Clarissa SpencerChurchill, the niece of the Prime Minister. In May 1945, Eden was diagnosed as having a duodenal ulcer. In 1952 he had several attacks of upper abdominal pain, some of which required analgesic injections and one that was apparently accompanied by transient jaundice. In April 1953, Eden had yet another attack of severe upper abdominal pain. X-rays revealed the presence of gallstones and Sir Horace Evans, physician to the Queen, was called in. Sir Horace advised urgent surgery. On 12 April 1953 at the age of 55, surgery was performed in London by Mr John Basil Hume, senior surgeon at St Bartholomew’s Hospital, and assisted by Mr Guy Blackburn, general surgeon at Guy’s Hospital. No one can be certain what happened during this operative procedure, however, putting together the information obtained from several sources the most likely scenario is that, during cholecystectomy, Anthony Eden sustained an injury of the proximal common hepatic duct at its bifurcation and possibly, also, an injury of the right hepatic artery, as shown in Fig. 1. On 29 April 1953, a little over 2 weeks after the initial operation, further surgery was performed by Mr Hume, apparently to drain a bile collection and presumably also to attempt to reconstruct the bile duct. This was unsuccessful. In May 1953 while Anthony Eden was still in hospital recovering from his second operation, Dr Richard Cattell, surgeon at the Lahey Clinic in Boston and an internationally known expert in biliary and pancreatic surgery, happened to be on a lecture tour in London and was invited to give an opinion on Eden’s condition. Cattell’s view was that a further operation should be performed. At that time, Cattell had more experience with bile duct reconstruction necessitated by operative injury, sustained usually during cholecystectomy, than anyone else in the world. Shortly after this consultation, Eden travelled to Boston, and Dr Cattell performed a hepaticojejunostomy over a Y-tube, as shown in Fig. 2, with an entero-anastomosis below the reconstruction, this being an attempt to divert the alimentary stream away from the bile ducts. This operation was successful, at least in the short term. Eden recuperated in the USA and returned to London in October 1953. While he was away, Churchill took over the Foreign Office. At the end of June 1953, Churchill suffered a serious stroke, however he made a most remarkable recovery and continued in office as Prime Minister until April 1955. At this time, Anthony Eden took over from Churchill as Prime Minister. On 26 July 1956 Colonel Nasser seized the Suez Canal. This followed a long period of Egyptian opposition to what they regarded as a Canal Zone occupation, starting with King Farouk’s demand for total and immediate withdrawal of British Troops from the Suez Canal in 1950. Ten weeks later, on 5 October 1956, Eden collapsed with a high temperature of 106 ° F. This, 3 1 / 2 years after his bile duct repair, was the first of several major attacks of pain, rigors and fever, which he apparently suffered for the rest of his life. Three weeks after his collapse on 27 October 1956, Israel invaded Egypt and a further 4 days later, Eden ordered the Anglo-French forces to occupy the Suez Canal Zone, on the pretext of separating Egypt and Israel. This action caused an uproar in the British parliament, in the USA and also at the United Nations. In response to this, all parties agreed to an early ceasefire on 6 November 1956, and 3 weeks after this occupation, on 23 November 1956, the Anglo-French troops began to withdraw G. Kune MD, FRACS, FRCS, FACS.