. Manual of operative surgery. Fig. 696.—Finneys block tin scoop. outside the gall-bladder greatly aids. Often stones lying in the cystic andrarely the common ducts may be coaxed by the finger (outside the bladder)up into the bladder and so removed. Too much time must not be expendedin trying to coax such stones into the bladder, as other and surer means ofextracting them are available. Once more explore the interior of the gall-bladder with the linger. When exploring the gall-bladder after it has beenopened, much information may be obtained by palpating with a finger of onehand inside the vis
. Manual of operative surgery. Fig. 696.—Finneys block tin scoop. outside the gall-bladder greatly aids. Often stones lying in the cystic andrarely the common ducts may be coaxed by the finger (outside the bladder)up into the bladder and so removed. Too much time must not be expendedin trying to coax such stones into the bladder, as other and surer means ofextracting them are available. Once more explore the interior of the gall-bladder with the linger. When exploring the gall-bladder after it has beenopened, much information may be obtained by palpating with a finger of onehand inside the viscus and the fingers of the other hand outside it, but inside thebelly. Occasionally one finds the gall-bladder apparently divided into two ItiVfR5>0N 5uTji>e. &.-; / PcmreitcAi? cul eiAMe* f^. Fig. 697.—Jones cholecystostomy. cavities, both containing calculi. The septa between such cavities requiredivision before the stones can be removed. The methods of establishing atemporary fistula into the gall-bladder have undergone a number of edges of the wound in the viscus were at first sutured to the skin, laterto the aponeurosis or to the peritoneum. The resulting fistula was almostalways slow to close and sometimes failed do so; hence surgeons sought toinvert the edges of the gall-bladder wound so that on removal of the drainage CHOLECYSTOSTOMY 569 tube, which was and is always used, peritoneal surfaces would be left incontact and healing be rapid. W. D. Jones devised a suture for invertingthe edges of the gall-bladder wound and attaching it to the parietes. Hepulled the viscus well out of the abdomen and sutured it to the parietalperitoneum at a distance from the wound in it (Fig. 697). He next passeda catgut suture throug
Size: 1548px × 1614px
Photo credit: © The Reading Room / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bookcentury1900, bookdecade1920, bookpublisherphila, bookyear1921
