. American practice of surgery ; a complete system of the science and art of surgery . In this operation the portion of the duodenum involved is near thepoint of entrance of the common duct; observations upon the cadaver have shownthat, in a considerable proportion of cases, the duct of Santorini and the ductof Wirsung enter the duodenum at a considerable distance from the entrance of SURGICAL 1)ISI*]ASES OF STOMACH AND (ESOPHAGUS. 377 tho oomnion (hict, and they are often so small that it is difficult to recognize themduring this operation. Conseciuently they might easily be injured. Kuemmels
. American practice of surgery ; a complete system of the science and art of surgery . In this operation the portion of the duodenum involved is near thepoint of entrance of the common duct; observations upon the cadaver have shownthat, in a considerable proportion of cases, the duct of Santorini and the ductof Wirsung enter the duodenum at a considerable distance from the entrance of SURGICAL 1)ISI*]ASES OF STOMACH AND (ESOPHAGUS. 377 tho oomnion (hict, and they are often so small that it is difficult to recognize themduring this operation. Conseciuently they might easily be injured. Kuemmels Gastro-Duodenostomy. This operation consists in severing the duodciuuii beyond the contraction,closing its i)roximal end, and implanting its distal end into the pyloric end ofthe greater curvature of the stomach, as shown diagrammatically in The same objections which have been mentioned in connection withpyloroplasty, as well as with Willards gastro-duodenostomy, would apply tothis operation. Before we leave the discussion of this form of treatment of pyloric obstruction,. Fig. 143.—Finneys Pyloroplasty; Fifth Stage of the Operation. Tlie diagram shows the pos-terior row of continuous througli-and-through catgut sutures in place. due directly or secondarily to the presence of gastric ulcer, it may be well tostate that gastro-enterostomy in itself is usually sufficient to relieve chronic orrecurrent ulcer of the pyloric end of the stomach; and, in case of bleeding ulcerof the stomach, this treatment in itself is usually sufficient to relieve the patientpermanently, provided the gastro-enterostomy opening is made at the lowestpoint of the stomach and is sufficiently large. The greatly reduced condition of patients suffering from this conditionoccasionally, though rarely, makes it seem proper to add to the gastro-enteros-tomy a gastrostomy, as illustrated in Fig. 149, so that it may be possible to intro-duce food into the intestines in these cases without the danger of
Size: 1681px × 1487px
Photo credit: © Reading Room 2020 / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bookcentury1900, bookdecade1900, booksubjectsurgery, bookyear1906
