Identifier: annualanalytica02sajo (find matches)
Title: Annual and analytical cyclopaedia of practical medicine
Year: 1898 (1890s)
Authors: Sajous, Charles E. de M. (Charles Eucharist de Medicis), 1852-1929
Subjects: Medicine Medicine
Publisher: Philadelphia : F.A. Davis Co.

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ifficult enoughand suture of the normal duct is out ofthe question, says one. Tt is not worthwhile to exercise great care in sewing upa slit in the common bile-duct, for it isalmost impossible to prevent leakage,and a little additional leakage can do noharm if one drains, says another. Waituntil the common duct dilates andthickens before venturing to open it, sayall surgeons. Halsted states that he has ascertainedfrom operations on dogs and man thatthe normal bile-ducts can be suturedeasily, accurately, almost infallibly, andwithout danger of leakage or constric-tion. He approves of Langes suggestionto cut through one or two ribs and thediaphragm, if it is necessary thus torender the parts operated upon more ac-cessible. He then describes small ham-mers, the heads of which, being of vari-ous sizes, he inserts into the commonduct, after the incision has been madeand the stone removed. The contentsare thus prevented from escaping, andtlic duct can l)e raised or lowered at will ffftmrfor
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Suture of the Bile Ducts.(Halsted. JOHNS HOPKINS HOSPITAL BULLETIN. BURK a UcFETRinEE CO imtpmi CHOLELITHIASIS. SURGICAL TREATiMENT. 209 by the operator. The wall is moreeasily sutured over the head of the ham-mer. He has a series of hammers whichhe attaches to a long handle, using oneof proper size to easily enter the duct.The method is graphically shown in theannexed colored plate, while the ham-mer and the various diameters of thelatter employed are illustrated here. Literature of 96 and 97. Series of 209 laparotomies for gall-stones -with special reference to 30 casesof eholedoehotomy. He classifies hisoperations into five groups:—• 1. Those in which the stone is foundin the gall-bladder or cystic duct; 97one-sided and 3 double-sided cholecys-totomies, 4 cystendysis and 23 cystecto-mies. Altogether 127 gall-bladder opera-tions with but 1 death. 2. Two cystectomies and 1 death. 3. Stone in choledoch-duct which couldnot be moved into the gall-bladder or duo-denum; 30 choledochot

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