. Manual of operative surgery. 4 to 2 inches wide of the disease at least(Mayo Robson). As malignant disease does not, as a rule, iniiltrate towardsthe duodenum, the division of the duodenum may be made at a point about^^ to I inch away from the disease. In excising glands from the great. Fig. 531.—Lj^mphatics of stomach. omentum there is great danger of wounding the middle colic artery and therebycausing gangrene of the transverse colon. The glands along the greater curva-ture are most numerous near the pylorus. (Mayo Robson, Surg. TreatmentDiseases of the Stomach.) This danger is avoided in
. Manual of operative surgery. 4 to 2 inches wide of the disease at least(Mayo Robson). As malignant disease does not, as a rule, iniiltrate towardsthe duodenum, the division of the duodenum may be made at a point about^^ to I inch away from the disease. In excising glands from the great. Fig. 531.—Lj^mphatics of stomach. omentum there is great danger of wounding the middle colic artery and therebycausing gangrene of the transverse colon. The glands along the greater curva-ture are most numerous near the pylorus. (Mayo Robson, Surg. TreatmentDiseases of the Stomach.) This danger is avoided in the method describedbelow. In view of the facts stated in the preceding paragraphs, it follows that theoriginal operations of pylorectomy were defective in extent. When a sufficiencyof the viscus is removed, it will rarely, if ever, be possible to unite the open endof the duodenum to the open end of the stomach (partially closed by sutvures),and when possible it will be much more difficult, time-consuming, and riskythan the methods to be described. Pylorectomy or Partial Gastrectomy.—Step- i.—Open the abdomen,usually by a longitudinal incision between the ensiform cartilage and theumbiHcus. Explore the abdomen. Step 2.—Tear a hole in the thin portion of the lesser omentum
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