Staphylococcal Muscle Invasion and Anuria.

ducts with dilatation and obstruction of the common bile duct. The second operation was undertaken on February 24, I962, i.e. about two months after the first, under general intubation aniesthesia. The old scar was excised. Adhesions of the colon and great omentum to the gallbladder were dissected. The common bile duct, which was found to be dilated (about 1.5 cm. in diameter), was explored through an incision below the junction of the cystic duct; two dark-greenish (bilestained) daughter cysts were removed from the common bile duct at the entrance of the cystic duct. The common bile duct was probed and dilated using Bakes dilators and a T-tube choledochostomy instituted. Cholecystectomy was also done; the gallbladder was removed with some difficulty due to dense adhesions from previous inflammation and surgery (Fig. i). A post-operative 'T' cholangiogram done on March 9, I962, i.e. 12 days after the second operation, showed a free passage of the dye into the duodenum with no apparent obstruction of the common bile duct. The T-tube was removed on the same day; this was followed by no drainage of bile at all. All wounds healed well and the patient left the hospital on March 12, I962, in a very satisfactory condition.