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December 8, 1917


Author Affiliations

Fellow of the American College of Surgeons; Professor of Clinical and Operative Surgery, Medical College of Virginia RICHMOND, VA.

JAMA. 1917;LXIX(23):1943-1945. doi:10.1001/jama.1917.02590500025006

At this time gallbladder surgery is occupying the attention of surgeons perhaps more than any other subject. The reason for its prominence is obvious. Cholecystostomy, once the operation of choice, has been denounced by an able coterie of surgeons as giving permanent results in not more than half of the cases; and cholecystectomy, a supposedly more dangerous operation, is being substituted for it whenever conditions allow.

All are familiar with the condition found at operation after a previous cholecystostomy. Often the liver is turned up at its lower border and lies on a level with or above the costal margin, having diaphragmatic and peritoneal adhesions. The duodenum, transverse colon and stomach are often adherent to the gallbladder and the liver. I believe this is due entirely to the drainage, which does not allow the liver to assume its normal position, and which, in my opinion, is responsible for the adhesions

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