Surgical treatment; a practical treatise on the therapy of surgical diseases for the use of practitioners and students of surgery . t the tendency of the mucous membrane to projectmay be obviated by cutting the stomach wall obliquely so that more of themucosa is cut away than the seromuscularis. Drainage should only beused if there has been accidental soiling of the wound (for After-treatment,see page 776). Resection of the pyloric end of the stomach (partial gastrectomy andpylorectomy) in the hands of experienced surgeons gives a mortality of 8 or 10per cent. Assuming a growth, the center of
Surgical treatment; a practical treatise on the therapy of surgical diseases for the use of practitioners and students of surgery . t the tendency of the mucous membrane to projectmay be obviated by cutting the stomach wall obliquely so that more of themucosa is cut away than the seromuscularis. Drainage should only beused if there has been accidental soiling of the wound (for After-treatment,see page 776). Resection of the pyloric end of the stomach (partial gastrectomy andpylorectomy) in the hands of experienced surgeons gives a mortality of 8 or 10per cent. Assuming a growth, the center of which is in the last third of thestomach close to the middle third on the anterior wall at the lesser curvature,the operation should consist of resection of the distal half of the technic of operation as practised by W. J. Mayo and described by him(Jour. Am. Med. Assoc, May 14, 1910) is as follows: The lesser peritoneal cavity is opened through the gastrohepatic superior pyloric artery is ligated in two places as far as possible fromthe duodenum and cut between the ligatures. The superior border of the. Fig. 1424.—Pylorectomy with End-to-end Anastomosis of Stomach and Duodenum duodenum is thus freed for a distance of 4 or 5 cm. {i}^ or 2 inches). Theobject of this step is to include the glands which lie beside the artery. Itshould be remembered that the common bile duct lies close to the artery andmust not be injured. Adhesions of the stomach or duodenum to the liver should be stomach should be drawn downward and to the right and the gastricartery caught and ligated close to the celiac axis. This artery is best tiedby passing a ligature in a needle and tying securely. The anterior andposterior gastric branches should be caught and tied so that the fat andglands and distal part of the vessel can be dissected free from the upper partof the lesser curvature, exposing a space 3 cm. (1^ inches) in extent next tothe cardiac orifice. This dissec
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Keywords: ., bookcentury1900, bookdecade1920, booksubjectsurgery, bookyear1920
