Cholecystotomy : with a report of two new cases, a table of all the hitherto reported cases, and remarks / by J.H. Musser and W.W. Keen.
- John Herr Musser
- Date:
- [1884]
Licence: Public Domain Mark
Credit: Cholecystotomy : with a report of two new cases, a table of all the hitherto reported cases, and remarks / by J.H. Musser and W.W. Keen. 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.
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![gestion of Handfield Jones to endeavor to push them into the duodenum should be tried. This faihng, we should endeavor to push them back into the gall- bladder—a manipulation much more likely to suc- ceed, for this part of the ducts has already been dilated by their onward passage. Yery possibly the}'' may be so fixed as to be immovable (Tait). Whether we can find any stones or not, if the blad- der be distended with fluid, it should now be aspi- rated, the scoop alread}'^ desci'ibed being used to carry off any liquid contents, thus preventing its escape into the peritoneal cavity, and at the same time to keep back the intestines, which would other- wise tend to escape. The gall-bladder should now be incised to the extent of an inch, or more if necessary, the scoop still serving as a conduit for any escaping fluid. By the probe and various ordinary forceps any gall- stones may now be discovered and removed. It is not always easy to find all the stones that are present. In Bobbs's case, and in one of Tait's, a stone known to exist had to be left. In the former it was probably sacculated, but at all events, though felt, it could not be reached. In Tait's it was in the common duct, and could not be removed. [Because of adhesions?] The case recovered, but with a pin- hole fistula. All the bile escapes at the fistula and none into the bowels. Three times he has tried to close it, but each trial was followed by severe bilious colic, until the bile re-escaped in about fifty hours. In this case he proposes to re-open the abdomen and crush the stone in situ with padded forceps outside](https://iiif.wellcomecollection.org/image/b2229546x_0058.jp2/full/800%2C/0/default.jpg)
