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I will invite your attention for a few moments to obstruction of the cystic duct, a region only recently invaded by the surgeon; a subject not alluded to in Mutter's Syllabus of 1883, nor found in Cheyne's of 1892.
That the treatment of hepatic disease remained in the field of medicine until within a recent period is proven by the fact that the surgical treatment of the liver by cholecystotomy was first performed by Dr. Bobbs, of Indianapolis in 1867.
In obstruction of the cystic duct there is occlusion, or stenosis. In the first the closure is complete: in the latter less complete. These conditions are dependent on foreign bodies within the duct, or upon some disease or thickening of the walls, or the presence of pressure from a tumor without. The most common cause is an impacted gall-stone in the cystic duct. If the cystic duct alone is obstructed,
MYERS WH. OBSTRUCTION OF THE CYSTIC DUCT, WITH A CASE. Read in the Section of Surgery and Anatomy, at the Forty-third Annual Meeting of the American Medical Association, held at Detroit, Mich., June 7, 1892. JAMA. 1892;XIX(6):160–162. doi:10.1001/jama.1892.02420060014001d
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