. Modern surgery, general and operative. mpis buried by Cushings right-angledsuture or Dupuytrens suture. Agastrojejunostomy is then performedto the posterior wall of the portion ofstomach which remains. Such a patient is usually muchdehydrated, and if he is, salt solutionshould be given intravenously duringthe operation, and an enema of warmsalt solution should be administeredevery six hours for several daysafter the operation. Active stimu-lation is usually necessary and 8 coffee should be given by rectumat the completion of the patient must be placed erect orsemi-erect i
. Modern surgery, general and operative. mpis buried by Cushings right-angledsuture or Dupuytrens suture. Agastrojejunostomy is then performedto the posterior wall of the portion ofstomach which remains. Such a patient is usually muchdehydrated, and if he is, salt solutionshould be given intravenously duringthe operation, and an enema of warmsalt solution should be administeredevery six hours for several daysafter the operation. Active stimu-lation is usually necessary and 8 coffee should be given by rectumat the completion of the patient must be placed erect orsemi-erect in bed as soon as theeffects of the^ ether pass hours after operation beginto give small amounts of hot waterby the mouth. Nourish by therectum from four to six days, whenfluid food may be given by the mouth, starting with small doses of albumin-water, and, if this is tolerated, giving dessertspoonful doses of peptonized milk every hour. From Jan. i,1906, until Jan. i, 1918, there were 589 resections in the Mayo clinic with a. Fig. 73S.—Pylorectomy by the Mayo method:End of divided duodenum buried by a purse-string suture. Row of lock stitches inserted instomach stump (Mayo). 1224 Diseases and Injuries of the Abdomen mortality of per cent. Their mortality after resection for ulcers and benigntumors is very small. If during the operation the pancreas be wounded theclosed end of the duodenum is appUed directly to the pancreatic wound, asWilly Meyer suggested (Trans, of Am. Surg. Assoc, 1910). The anteriorperitoneum and adventitious sheath of the pancreas are then sutured to theanterior surface of the duodenum. This plan prevents leakage from the duo-denum and pancreas (Wm. J. Mayo, in Annals of Surgery, August, 1913). Total Gastrectomy.—The entire stomach was first removed by Conner,of Cincinnati, in 1883. The first successful operation was performed bySchlatter, of Zurich, in 1897. Total gastrectomy will rarely be required, but incertain unusual cases it will
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