Interstate medical journal . eration, (3) the cholesteringallbladder of Moynihan, (4) chronic empyema, (5) gangrene, (6) carcinomalimited to the gallbladder itself, (7) extensive laceration or perforation of thegallbladder. Crile advises cholecystectomy (1) if the cystic duct is occluded, (2) if thecystic duct has a decubitus, (3) if the gallbladder wall is injured by gives all indications cited above, and concludes that it is his Guthrie: Cholecystectomy 767 belief that any gallbladder that is worth operating on may with advantagebe removed. Erdman says cholecystectomy limi
Interstate medical journal . eration, (3) the cholesteringallbladder of Moynihan, (4) chronic empyema, (5) gangrene, (6) carcinomalimited to the gallbladder itself, (7) extensive laceration or perforation of thegallbladder. Crile advises cholecystectomy (1) if the cystic duct is occluded, (2) if thecystic duct has a decubitus, (3) if the gallbladder wall is injured by gives all indications cited above, and concludes that it is his Guthrie: Cholecystectomy 767 belief that any gallbladder that is worth operating on may with advantagebe removed. Erdman says cholecystectomy limits morbidity and increases efficiency. Asa result he is performing cholecystectomy in almost every case, althoughthere are some cases in which cholecystostomy must be performed. Crile believes that the clinical results of cholecystectomy are better thanthose of cholecystostomy, just as nephrectomy for a pus kidney is better thannephrotomy. He has never seen any adverse clinical results following ex-cision of the Fig. 4.—Split in gastrohepatic omentum being closed, covering cut ends ofcystic artery and duct; suturing cut edges of serosa. Babcock recommends cholecystectomy in the first stages of cholecystitis,but emphasizes many of the technical dangers. C. H. Mayo says cholecystostomy and the removal of stones will curesymptoms of mechanical obstruction, but does not cure chronic cholecystitisand cannot restore the destroyed walls of the gallbladder or free it fromadhesions. He advises cholecystectomy for these and for all cases in whichinfection is the major feature, with or without stones. Chronic pancreatitiswith gastric symptoms cannot be cured by cholecystectomy, but requires pro-longed drainage. Question 5: What are the contraindications for cholecystectomy? 768 INTERSTATE MEDICAL JOURNAL The chief ones may be said to be the following: Inexperience of theoperator. Inexperience of the anesthetist; one who may not appreciate thefact that manipulations about t
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