The subject of cholecystitis is of especial interest because of its dependence on primary foci of infection in more exposed parts of the alimentary tract, and because of its relation to the pathologic changes in the regional lymphatics of the ducts, liver and pancreas. It is common knowledge among experienced observers that gallbladder disease is often associated with appendicitis, with ulcerations of the stomach, duodenum, ileum or colon, and with systemic diseases. Infection from these sources is believed to be carried very often by way of the portal vein and its tributaries to the liver, where it is either destroyed or returned through the lymphatics of the bile passages and pancreas. It is remarkable that the fluctuations in the blood sugars of cases of cholecystitis appear to correspond fairly closely with the extent of involvement of these pancreatic and biliary lymphatics. The suggestion arises from these observations that rational treatment
BARBER WH. CHOLECYSTITIS AND ITS RELATION TO PANCREATITIS: A CLINICAL AND EXPERIMENTAL STUDY. JAMA. 1926;87(20):1635–1639. doi:10.1001/jama.1926.02680200035010
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