. Annals of surgery . rained seven years before, afterremoval of stones by Dr. G. Reoperation revealed an hour-glass stricture ofthe gall-bladder. Compartment at fundus filled with stones below stricture(probable former purse-string site). The gall-bladder was thickened andmfiltrated. The cystic duct was ligated with artery and vein, and cholecystectomymade. The drain was inserted down to the stump. There was free flow of bileon second day. The wound healed, and the patient was discharged July 23, ist. The patient was sent to the hospital with a chill and fever;leucocytes 15,400,
. Annals of surgery . rained seven years before, afterremoval of stones by Dr. G. Reoperation revealed an hour-glass stricture ofthe gall-bladder. Compartment at fundus filled with stones below stricture(probable former purse-string site). The gall-bladder was thickened andmfiltrated. The cystic duct was ligated with artery and vein, and cholecystectomymade. The drain was inserted down to the stump. There was free flow of bileon second day. The wound healed, and the patient was discharged July 23, ist. The patient was sent to the hospital with a chill and fever;leucocytes 15,400, pulse 100; temperature , urine highly colored; stools lightcolored. The temperature was normal on the fourth day and the patient wasdischarged on December 7, igi8. February 11, 1919. The patient returns to the hospital with jaundice, nausea,and vomiting; pruritus. Operation.—The abdomen was opened through the old scar. The commonduct was identified and opened. The probe passed downward easily into duodenum 135. LEWIS L. McARTHUR without obstruction; passed upward to meet the obstruction near the hilus of theliver. The duct was spHt upwards along the probe to the obstruction, due toconnective tissue constriction and scar-tissue. A portion of a small No. 7 softrubber catheter was inserted with funnel, and was inserted above the constriction,and the other end was passed down into duodenum and then closed over catheter,and a Bullitt drain inserted to the field of the suture. Drain was removed on the seventh day, February i8th, stools normal on the second day. The patient returned _,, a home, healed, on March 3, 1919. 3» After one and three-quarter j years of comparative comfort. the patient again showed jaimdice. On December 14, 1920. the abdomen required re- ; opening. The common duct was reached through the ad-hesions without seeing freeperitoneum. Opening the same,revealed a black silk suture asthe nucleus of a gall-stone atsite of former stricture. It wasdeemed advisab
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Keywords: ., bookcentury1800, bookdecade1880, booksubjectsurgery, bookyear1885
