Report of cases of cholecystotomy : with special reference to the treatment of calculus lodging in the common duct / by A. Vander Veer.

  • Vander Veer, A. (Albert), 1841-1929.
Date:
1891
Catalogue details

Licence: Public Domain Mark

Credit: Report of cases of cholecystotomy : with special reference to the treatment of calculus lodging in the common duct / by A. Vander Veer. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

    3/10 (page 1)
    [Reprinted from the Transactions of the Association of American Obstetricians and Gynecologists, September, 1891.] REPORT OF CASES OF CHOICE CYSTOTOMY, WITH SPECIAL REFERENCE TO THE TREATMENT OF CALCULUS LODGING IN THE \ COMMON DUCT. By A. VANDER VEER, M.D., PROFESSOR OF DIDACTIC, ABDOMINAL, AND CLINICAL SURGERY, ALBANY MEDICAL COLLEGE, CONSULTING SURGEON ST. PETER'S HOSPITAL, ATTENDING SURGEON ALBANY HOSPITAL, FELLOW BRITISH GYNECOLOGICAL SOCIETY, AMERICAN SURGICAL ASSOCIATION, AMERICAN ASSOCIATION OF OBSTETRICIANS AND GYNECOLOGISTS. In presenting this paper as a contribution on the surgery of the gall-ducts, I shall refer somewhat to the surgery of the gall-bladder, yet my chief desire is to get from you a dis- cussion and your views regarding a line of treatment in cases where we find a contracted and perhaps almost oblit- erated gall-bladder, or where the common cystic or hepatic ducts are entirely closed by lodgment of a calculus, or stenosis from other causes. I take it that most abdominal surgeons are ready to treat, and feel that they are doing quite full jus- tice in treating, a case like the following according to the methods now employed : Case I.—Mrs. S. St. 0., aged forty, married, native of United States, and by occupation a housewife. Family history good; patient had had all diseases of childhood ; first menstruation at fourteen ; always regular; mar- ried twenty-two years; mother of eleven children; youngest twenty-two months old. First began to feel ill about two years ago. July 12, 1890, patient had a severe pain over region of gall-bladder, and simultaneously a bunch appeared in right side. Pain lasted about four weeks, when she began to improve, but has had repeated attacks at intervals since. Has had sensa- tion of weight in right side since first attack. Appetite poor ; continuously jaundiced since about four months ago, which would fade and recur with attacks of colic. In March, 1891, began itching, which was limited to chest. This disappeared for a week, then reappeared on arms, lasting again for a week, and reappeared again in May last, this time being general over every part of body and did not abate. Physical examination: Fluctuating tumor in the region of the gall- bladder, tender on pressure ] pregnancy advanced three months; skin intensely yellow. In view of her constant emaciation, the itching yielding to no treatment, notwithstanding her pregnancy I advised an immediate operation. She was accordingly admitted to the Albany Hospital June 18, 1891. was placed in a private room, and given the usual preparatory treatment, for abdominal section. Operation, June 20th. Vertical incision over gall-bladder, which was stitched to abdominal parietes and opened. Gall-stones, sixty-four in num- ber, removed, varying in size from a hickory-nut to a small pea, and which I here exhibit. Silver probe was passed through the common duct into the