260 Anatomy Applied to Medicine and Surgery. 



Carcinoma of the pancreas was found one hundred and 

 twenty-seven times in eleven thousand four hundred and 

 ninety-two post-mortems, and, when present, generally 

 involved the head. In addition to the usual symptoms of 

 cancer, the common bile duct is often, in carcinoma, com- 

 pressed on account of its close relationship to the head of 

 the 'pancreas, thus causing an intense and persistent jaun- 

 dice associated, as a rule, with a dilated gall bladder. 



Surgery of the Pancreas. In operative work 

 on the pancreas an incision in the middle line between the 

 umbilicus and the ensiform cartilage is generally employ- 

 ed, but, if a tumor be present on the left side, the incision 

 may be placed over it. The great omentum is divided 

 near the stomach, the latter is drawn upwards, the colon 

 is depressed, and the pancreas, or cyst, etc., is exposed. 



