Operative surgery of the gall tracts with original report of twenty successful cholecystenterostomies by means of the anastomosis button . e gallbladder a similar running thread is inserted. Fig. 4. An incison isnow made in the intestine, in length two-thirds of the diameter ofthe button used. One part of the button is slipped in, the runningstring tied, and the button held with the forceps. The contentsof the gall bladder is withdrawn with an aspirator. An incision isthen made in the gall bladder the same length, and between therows of sutures, the other part of the button is inserted in a si
Operative surgery of the gall tracts with original report of twenty successful cholecystenterostomies by means of the anastomosis button . e gallbladder a similar running thread is inserted. Fig. 4. An incison isnow made in the intestine, in length two-thirds of the diameter ofthe button used. One part of the button is slipped in, the runningstring tied, and the button held with the forceps. The contentsof the gall bladder is withdrawn with an aspirator. An incision isthen made in the gall bladder the same length, and between therows of sutures, the other part of the button is inserted in a similar 19 manner, and the running string tied. The forceps are removed andeach half of button held between the fingers and pressed together,Fig. 5. A sufficient degree of pressure must be used to bring the ser-ous surfaces of the gall bladder and intestine firmly in contact andcompress the tissues. The elastic pressure of the spring cup ofthe button produces a pressure atrophy of the tissue embracedwithin the cup, and leaves an opening as large as the button, thebutton dropping into the bowel and being passed through the Figure 4.—Running threads in position in gall bladder and duodenum. It takes about as long to describe the operation as to performit. The time occupied with the first patient on whom I operatedwas eleven minutes, from the entering of the peritoneal cavity untilthe closing of it. On dogs I was from eleven to eighteen minutesin performing the operation, the latter time being on the first dog,before I had made the various improvements in the technique andbutton. The operation is more difficult to perform on the dog thanon man, as it is more difficult to bring the gall bladder into thewound. To show that this operation is one that the busy surgeon willbe frequently called upon to perform, now that the technique is 20 simple, we have only to reflect on the number of cases of chronicjaundice from obstruction of the common gall duct, requiring someopera
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Keywords: ., bookcentury1800, bookdecade1890, booksubjectgallbla, bookyear1894
