Large bile cyst of the liver : jaundice without cholelithiasis : incision and drainage : recovery / by Alban Doran.

  • Doran, Alban H. G. (Alban Henry Griffiths), 1849-1927.
Date:
[1903]
Catalogue details

Licence: In copyright

Credit: Large bile cyst of the liver : jaundice without cholelithiasis : incision and drainage : recovery / by Alban Doran. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    and two pints eiglit ounces of pure deep green bile were removed. When it collapsed the relations of the cyst puzzled me at first ; but on raising its lower part I found the gall- bladder perfectly healthy behind and below it. The cystic, hepatic, and common ducts were plainly visible, quite normal, and empty. The pancreas was soft and supple, and there were no omental or intestinal adhesions. The right lobe of the liver was enlarged, the surface was not irregular, but opaque from perihepatitis ; the left was of a uniform rich orange-brown colour, with the capsule quite free from opacity. No calculi nor any more cysts could be felt in the liver. The great cystic cavity occupied the lobulus quadratus and apparently the whole of the left half of the right lobe to the diaphragm and the back of the abdominal cavity. The gall-bladder was about three inches long, thin and flaccid ; it contained a little fluid, presumably clear, and was very movable ; the cyst had pushed it away from its groove. Its walls were healthy, and no calculi could be felt. The right kidney was healthy and mobile. I inserted a quarter-inch red rubber tube into the cyst and sewed the edges of the opening, which I made around the aspiration puncture, to the peritoneum at the upper angle of the wound. The rest of the peritoneum was united with a continuous No. 1 silk suture, the sheath of the rectus (I had not divided the lateral mnscles) in the same manner ; the wound in the integuments was closed with interrupted silkworm gut. The patient slept well a few hours after being put to bed; I withdrew on the same evening sixteen ounces of pure green bile. l)r. Cuthbert Lockyer examined the bile removed at the operation ; it contained no trace of clot or hydatid elements. The temperature during convalescence never exceeded 100°; the pulse wms 96 for several days. The itching disappeared within twenty-four hours. The area of lic]mtic dill ness was found to bo rednced to its normal