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Article
September 20, 1919

THE FAILURE OF SURGERY ON THE EXTRAHEPATIC BILIARY PASSAGESAN ANATOMICOCLINICAL CONSIDERATION

Author Affiliations

PHILADELPHIA

JAMA. 1919;73(12):892-895. doi:10.1001/jama.1919.02610380018006
Abstract

Before considering the anatomy of the structures in the region of the foramen of Winslow, it may be profitable to study the relation of the peritoneal bands and adhesions found in this region to the gallbladder, ducts and blood vessels to the surrounding organs and hollow viscera. It is a matter of some importance to decide whether these folds which extend from the gallbladder to the hollow viscera and the great omentum are really inflammatory in character, or whether they are simply developmental embryonal structures. The differentiation is important at operation. Adhesions usually are of denser texture, they are not so easily separated, and usually in themselves they are devoid of blood vessels which require ligation. The bleeding which occurs after adhesions have been separated is usually due to the raw surfaces left. If these bands continue as part of the lesser omentum, one can readily see distinct blood vessels

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