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January 24, 1903

A CONTRIBUTION TO THE SURGERY OF THE GALL BLADDER AND DUCTS.

JAMA. 1903;XL(4):224-232. doi:10.1001/jama.1903.92490040020001f
Abstract

ANATOMY.  The advancement of surgery to include the biliary passages has awakened a new interest in these structures and their relations. The surgeon found it necessary to go into the dissecting room and familiarize himself with the normal structures in this region. With this object in view, George Emerson Brewer,1 M.D., New York, dissected and studied 160 subjects to which I wish to refer you. Mr. Morrison2 has drawn attention to the lesser sac of the peritoneum in which the gall bladder exists, and many others have made valuable observations.The ninth costal cartilage is the external landmark of the gall bladder; in making an incision to expose it, the lower intercostal nerves should be avoided if possible. By making the perpendicular incision below the costal arch, and through the outer border of the right rectus muscle, only the ninth intercostal nerve is severed. There is not much variation in the normal position of the

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