Surgery of The Alimentary Tract Volume TwoPDF电子书下载

Chapter 5 THE PANCREAS 863

ANATOMY 863

EMBRYOLOGY AND HISTOLOGY 871

PHYSIOLOGY 872

GENERAL SURGICAL CONSIDERATIONS 874

METHODS OF EXPOSING THE PANCREAS 875

CONGENITAL MALFORMATIONS OF THE PANCREAS 879

Pancreas Divisum 879

Ectopic or Aberrant Pancreas 879

Annular Pancreas 881

Fibrocystic Pancreas 883

PANCREATIC INJURIES 883

Operative Treatment for penetrating and Nonpenetrating pancreatic Injuries 887

Treatment of Operative Injuries of the Pancreas 889

Incision for Biopsy 889

Injury to the Tail and Body of the pancreas 889

Injury to the Head of the Pancreas 890

PANCREATITIS 892

Acute Pancreatitis 892

Nonsurgical Treatment 896

Operative Treatment by Pancreatotomy and Drainage by the Transgastrocolic Route 899

Chronic Pancreatitis 900

Choledochal Sphincterotomy 902

Dilation of the Sphincter of Oddi 903

Choledochojejunostomy (Bowers) 904

Other Sidetracking Operations 905

Decompression procedures 905

Pancreatolithotomy 905

Sympathectomy 907

Ligation of Pancreatic Duct 916

Interlocking Mattress Ligation of Pancreas 916

Other Operations for Pancreatitis and Pancreatic Lithiasis 917

Results of Surgical Treatment of Chronic Relapsing Pancreatitis 917

CYSTS OF THE PANCREAS AND THEIR EXTENSIONS 918

Marsupialization of Pancreatic Cyst 920

Excision of a Pancreatic Cyst 922

Internal Drainage of Pancreatic Cysts 923

Roux-en-Y Cystojejunostomy 924

Partial Pancreatectomy Including Cyst in Resection 925

PANCREATIC FISTULAS 925

Excision of Pancreatic Fistula 926

Internal Drainage of Pancreatic Fistula 927

Excision of Tract Combined with Partial Pancreatectomy 927

Excision of Tract Combined with Sphincterotomy 928

ISLEI CELL TUMORS OF THE PANCREAS 928

Excision of Islet Cell Tumor of Pancreas 930

PAPTIAL PANCREATECTOMY:EXCISION OF THE TALL AND BODY OF THE PANCREAS 934

CARCINOMA OF THE PANCREAS 938

CARINOMA OF THE AMPULLA OF VATER 939

PANCREATODUODENAL RESECTION 940

One-Stage Pancreatoduodenal Resection (Trimble) 943

Two-Stage Partial or Total Pancreatoduodenal Resection (Whipple) 959

Two-Stage Partial or Total Pancreatoduodenal Resection (Cattell) 961

Complication s Following Pancreatoduodenal Resection 962

Results of Pancreatoduodenal Resection 964

PALLIATIVE OPERATIONS FOR INOPERABLE CARCINOMA OF PANCREAS 964

REFERENCES 966

Chapter 6 THE SPLEEN 969

ANATOMY 969

PHYSIOLOGY 970

ACCESSORY SPLEENS 970

SPLENOSIS 972

GENERAL SURGICAL CONSIDERATIONS 972

INCISIONS 973

EXPLORATORY PUNCTURE OF THE SPLEEN AND SPLENIC BIOPSY 973

TOTAL SPLENECTOMY 975

LIGATION OF SPLENIC ARTERY 990

PARTIAL SPLENECTOMY 990

SPLENOTOMY 991

SURGICAL TREATMENT OF WOUNDS OF THE SPLEEN 992

Abdominal Wounds of the Spleen 992

Transthoracic Wounds of the Spleen 995

SPLENOPEXY FOR SPLENOPTOSIS 996

POSTOPERATIVE CARE IN OPOERATION UPON THE SPLEEN 996

REFERENCES 997

Chapter 7 THE SMALL INTESTINE (JEJUNAL AND ILEAL PORTIONS) 999

ANATOMY 999

PHYSIOLOGY 1005

CONGENITAL ABNORMALITIES OF THE SMALL INTESTINE 1011

DISEASES OF THE JEJUNOILEUM 1017

Diverticulosis 1017

Tumors 1019

Primary Ulcer of the Jejunoileum 1024

Primary Jejunal Ulcer 1024

Primary Ileal Ulcer 1025

GENERAL SURGICAL CONSIDERATIONS IN OPERATING UPON THE INTESTINES 1026

ENTEROTOMY 1032

REPAIR OF INTESTINAL WOUNDS AND PERFORATIONS 1034

Repair of Wounds Due to Trauma 1035

Repair of Ulcerative Perforations 1039

ENTEROSTOMY 1040

Jejunostomy 1041

Temporary Jejunostomy 1043

Permanent Jejunostomy 1047

Jejunostomy Feeding 1049

Ileostomy 1051

Ileostomy with a Tube 1054

Ileostomy without a Tube:Tangential Ileostomy 1057

Ileostomy without a Tube:Double-Barrelled Ileostomy 1059

Ileostomy without a Tube:Double-Barrelled Ileostomy with Separation of the Stomas 1060

Ileostomy without a Tube:Stone Method 1062

Ileostomy without a Tube:Single-Barrelled Method 1066

Complications after Ileostomy 1072

Skin Grafting of Ileostomy Opening 1075

Closure of Enterostomy Stomas 1076

Closure of a Maydl Jejunostomy Stoma 1076

Closure of a Tangential,Loop or Double-Barrelled Ileostomy Stoma 1077

Closure of a Single-Barrelled Ileostomy Stoma 1079

Closure by the Intraperitoneal Route 1079

Summary of Enterostomy and Its Closure 1080

CLOSURE OF FISTULAS OF SMALL INTESTINE 1080

Closure of External Fistula 1080

Closure of Internal Intestinal Fistula 1089

Postoperative Care in Closure of Fecal Fistula 1091

Comments on Closure of Fecal Fistula 1092

PARTIAL ENTERECTOMY 1092

ANASTOMOSIS OF THE INTESTINE 1098

Lateral (Side-to-Side) Anastomosis after Enterectomy 1099

End-to-End Anastomosis 1107

End-to-Side Anastomosis 1132

Closed Side-to-Side Anastomosis 1135

Comparison of Intestinal Anastomosis 1135

OPERATIONS FOR SHORT-CIRCUITING (EXCLUSION,BY-PASSING) A SEGNENT OF INTESTINE 1137

Partial Short-Circuiting of a Segment of Small Intestine by Lateral Anastomosis between Its Limbs 1137

Partial Exclusion of a Loop of Bowel 1139

Complete (Bilateral) Exclusion of a Segment of Intestine 1139

INTESTINAL OBSTRUCTION 1140

Paralytic Ileus 1143

Dynamic (Spastic) Ileus 1145

Mechanical Intestinal Obstruction 1146

Intestinal Obstruction from Adhesions 1160

Plication of the Small Intestine for Adhesions (Noble) 1163

Immediate Postoperative Obstruction 1168

Intestinal Obstruction from External Hernia 1172

Intestinal Obstruction from Internal Hernia 1173

Obstruction of the Small Intestine by Foreign Bodies 1173

Volvulus of the Small Intestine (Not Due to Malrotation) 1173

Other Types of Mechanical Obstruction 1176

Intestinal Obstruction Due to Mesenteric Vascular Occlusion 1176

MALROTATION OF THE INTESTINE 1181

First Stage of Midgut Rotation 1181

Second Stage of Midgut Rotation 1182

Third Stage of Midgut Rotation 1186

Omphalocele Resulting form Failure of Rotation beyond the First Stage 1186

One-Stage Operation 1188

Two-Stage Operation (Gross) 1191

Nonrotation Resulting from Failure in Second Stage 1199

Operation for Duodenal Obstruction Caused by Nonrotation of the Midgut (Ladd) 1200

Congenital Volvulus of Midgut Resulting from Abnormality of Second Stage 1200

Malrotation during Second Stage of Midgut Rotation 1207

Internal Hernia Resulting from Abnormality of Second Stage 1209

Reversed Rotation 1214

Subhepatic Cecum 1215

Retrocecal Appendix 1217

Mobile Cecum 1217

CONGENITAL ATRESIA 1218

CONGENITAL STENOSIS OF THE INTESTINE AND COLON 1232

MECONIUM ILEUS 1239

Surgical Lavage of Intestine through a Tube 1241

Resection of Obstructed Segment of Ileum with End-to-End Anastomosis 1242

Witzel Enterostomy 1242

Mikulicz Resection with Ileocolostomy 1242

Mikulicz Resection and Double Ileostomy 1243

Results of Surgical Treatment by the Various Methods 1244

Convalescent Care Following Surgical Treatment 1245

DUPLICATIONS OF THE ALIMENTARY TRACT 1246

Surgical Treatments 1253

Duplications Arising in the Thorax 1253

Duplications in the Thorax Arising from Intestine 1254

Duplications of the Stomach 1255

Duplications of the Duodenum 1255

Duplication of the Intestine 1256

Duplications of the Colon and Rectum 1256

Results of Surgical Treatment 1259

MESETERIC CYSTS 1259

MULTIPLE CYSTIC DISEASE OF THE MESENTERY 1262

OMENTAL CYSTS 1262

MECKEL＇S DIVERTICULUM 1263

INTUSSUSCEPTION IN INFANTS AND CHILDREN 1271

Surgical Treatment 1275

Reducible Intussusception 1276

Irreducible or Gangrenous Intussusception 1280

Recurring Intussusception 1290

Results of Surgical Treatment 1291

Nonsurgical Treatment 1291

INTUSSUSCEPTION IN OLDER CHILDREN AND ADULTS 1295

REGIONAL ENTERITIS (CROHN＇S DISEASE) 1297

Surgical Treatment 1306

Ileotransverse Colostomy with Transection of the Ileum 1307

One-Stage Resection 1308

Two-Stage Resections 1309

Comments on Surgical Treatment 1310

Recurrences 1312

REFERENCES 1314

Chapter 8 THE PERITONEUM,OMENTA AND MESENTERY 1319

ANATOMY 1319

OPERATIONS UPON THE PERITONEUM 1321

Surgical Treatment of Peritonitis 1321

Localized Peritonitis 1321

Diffuse Suppurative Peritonitis 1323

Prevention of Diffuse Peritonitis in Abdominal Injuries*1327+++Operations for Torsion(Volvulus)of the Omentum 1329

OPERATIONS ON THE GREAT OMENTUM 1328

Omental Grafting 1328

Partial or Complete Excision of the Great Omentum 1329

Operations for Torsion(Volvulus)of the Omentum 1329

Omentopexy for Cirrhosis of the Liver 1330

Removal of Cysts of the Omentum 1330

OPERATIONS UPON THE MESENTERY 1331

REFERENCES 1331

Chapter 9 THE COLON 1333

ANATOMY 1333

PHYSIOLOGY 1349

DEVELOPMENTAL ANOMALIES OF THE COLON 1352

DISEASES OF THE APPENDIX 1352

Appendicitis 1352

Acute Appendicitis 1353

Chronic and Chronically Recurring Appendicitis 1359

Appendiceal Abscess 1359

Other Lesions of the Appendix 1360

OPERATIONS UPON THE APPENDIX 1361

Appendectomy 1361

Drainage of Appendiceal Abscess 1371

Drainage of Pelvic Abscess 1373

Appendicostomy 1374

INJURIES OF THE COLON 1376

Surgical Treatment 1378

FOREIGN BODIES 1385

FECAL IMPACTION 1386

TUMORS OF THE COLON 1387

Benign Tumors 1387

Polyps or Multiple Polyps of the Colon 1388

Diffuse Familial (Multiple) Polyposis of the Colon 1393

Endometrioma (Adenomyoma) 1398

Other Benign Tumors of the Colon 1403

Malignant Tumors 1404

DIVERTICULA OF THE COLON 1416

DIVERTICULA OF CECUM 1434

PERSISTENT COLONIC FISTULAS 1435

Internal Persistent Colonic Fistula 1435

External Persistent Fecal Fistula 1436

NONSPECIFIC (IDIOPATHIC) ULCERATIVE COLITIS 1439

Pelvic Autonomic Neurectomy for Ulcerative Colitis 1461

CONGENITAL MEGACOLON (HIRSCHSPRUNG＇S DISEASE) 1462

Surgical Treatment 1469

One-Stage Abdominoperineal Resection of Rectosigmoid (Swenson) 1470

Colostomy for Congenital Megacolon 1477

Partial Colectomy for Congenital Megacolon 1480

Lumbar Sympathectomy 1480

Paravertebral Sympathetic Block 1487

VOLVULUS OF THE SIGMOID 1489

VOLVULUS OF THE CECUM 1497

Operation for Volvulus of Cecum 1498

GENERAL CONSIDERATIONS IN OPERATIONS UPON THE COLON 1498

COLOTOMY 1500

COLOPEXY 1502

COLOSTOMY 1503

Temporary Tube Colostomies 1507

Tangential Colostomy 1509

Double-Barrelled Colostomies 1512

Loop Colostomy 1512

Spur Colostomy 1521

Terminal Single-Barrelled Colostomy 1530

Complications after Colostomy 1533

Comments on Colostomy 1538

Care of Bowel and Stoma Following Permanent Colostomy 1540

Intraperitoneal Closure of a Colostomy Stoma 1542

OPERATIONS FOR SHORT-CIRCUITING THE COLON 1545

RESECTION OF THE COLON 1549

Resection of the Right Colon 1551

One-Stage Resection of Right Colon 1553

Two-Stage Resection of Right Colon 1562

Three-Stage Resection of Right Colon 1565

Mikulicz Exteriorization Resection (Lahey Modification) 1566

Comments on Resection of Right Colon 1569

Resection of the Transverse Colon 1570

One-Stage Resection with Primary Anastomosis 1570

Multiple-Stage Resection of Transverse Colon 1577

Obstructive Resection of Transverse Colon (Rankin) 1578

Resection of the Descending Colon and Sigmoid 1581

One-Stage Resection with Primary End-to-End Anastomosis 1581

Three-Stage Resection of Sigmoid (Schloffer) 1585

Mikulicz-Paul Resection of Sigmoid 1585

Other Methods 1587

Resection of Short Segment of Colon 1588

Colectomy 1589

One-Stage Colectomy with Ileostomy 1590

One-Stage Subtotal Colectomy with Ileorectotomy 1593

One-Stage Subtotal Colectomy with Ileostomy 1596

Total Colectomy with Anal Ileostomy and Preservation of Anal Sphincter (Ravitch) 1596

Two-Stage Total Colectomy with Permanent Ileostomy 1610

Two-Stage Subtotal Colectomy 1615

Three-Stage Total Colectomy with Ileostomy 1617

Four-Stage Total Colectomy 1622

Comments on Segmental,Partial,Subtotal and Total Colectomy 1625

REFERENCES 1629