The =stomach= is opened from the pylorus after the size of the latter
has been ascertained. The anterior wall may be cut midway between
the greater and lesser curvatures, or the cut may follow the greater
curvature, extending through the cardia into the œsophagus. As the
stomach is opened its contents are inspected and removed. They
should not be allowed to escape into the abdominal cavity. When the
organs are removed _en masse_ the stomach may be opened from the
cardiac end. The organ may also be opened by an incision through its
posterior wall or along its lesser curvature, as occasion may demand.
If it is desired to save the pyloric ring the incision may stop
above or below it and begin again on the other side. The stomach,
with the lower portion of the œsophagus and the superior portion of
the duodenum, may be separated from their attachments and examined
outside of the body.
The =pancreas= is examined by turning the stomach toward the
thoracic cavity, cutting or tearing the gastrocolic omentum, and
cutting the exposed organ by a longitudinal incision through head,
body and tail, or by means of parallel transverse incisions made
through the different parts of the organ. The ducts of Wirsung and
Santorini should be explored. It must be freed from the duodenum
before it is weighed. The pancreas may be removed in connection with
stomach, duodenum and liver and examined outside of the body. This
is advisable in all cases of perforation of the stomach, ulcer,
carcinoma and surgical anastomoses, carcinoma of pancreas, acute
pancreatitis, obstruction of common duct, duodenal ulcer, etc.
Public-domain text, read in full here on John Shaqi.
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