Manual of Operative Surgery

Cover Manual of Operative Surgery
Manual of Operative Surgery
Binnie, John Fairbairn, 1863-1936
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Close the excess of ab- dominal wound. By this method drainage by a rubber tube is provided from the gall-bladder (or common duct) through the new-formed bile-duct, through the duodenum, through the duodenal wall by an oblique canal out to the skin.
When repair is complete the tube is easily drawn out and the oblique duodenal fistula quickly closes. If any stenosis is threatened by the operation a gastro- enterostomy must be done.* Method IV. — A biliary fistula is present. It is believed that
...any ordinary method of cholecystenterostomy is impossible. It is desired to make the cutaneous opening of the fistula empty itself into the intestine.
Open the abdomen immediately to the right of the middle line. Choose a freely mobile loop of small intestine (one which may be made to reach the * It will probably be wise to perform a gastro-enterostomy in any of these complicated plastic operations because there is certain to be some stenosis and if any of the sutures cut loose there will be a fistula which, even if only temporary, will permit of the escape of the gastric contents and lead to starvation.


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