492 
DEPARTMENT OF SURGERY. 
knife it is well to ligate the large arteries, viz.: the gastric 
branch of the coeliac axis; the left gastro-epiploric as near 
the splenic artery as possible; and the right epiploric as 
near the hepatic as possible. The large arterial branches 
found in the omenta should also be ligated. The gastro¬ 
phrenic and the gastro-liepatic omenta should be severed first 
and all haemorrhage arrested ; and the gastro-splenic and the 
gastro-colic {great omentum ) next. When the stomach is 
disengaged it can be resected, but when only a part of it is to 
be resected, only the part of the omentum or omenta should be 
severed from the stomach that is diseased or involved in the 
structure to be removed. 
(Y) Resection of Part or Entire Stomach .—If part of the 
pyloric portion is to be removed, the walls of the stomach are 
divided and all haemorrhage is arrested, the direction of the in¬ 
cision and the amount of the organ resected will depend upon 
the extent of the disease ; and in every case the operator must 
adopt means of preventing the fluids of the stomach from escap¬ 
ing into the cavity, which is more difficult to accomplish than 
when the entire stomach is removed. When the resection is 
complete the ends are united by the simplest substantial method 
that can be employed to meet the requirements of the case.** If 
A, Lembert’s stitch ; b , Czerny’s stitch ; c, pylorus ; d, cardiac portion of the stomach ; <?, oeso¬ 
phagus ; f, duodenum. 
