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B Bokobza

Publications and source records attributed to B Bokobza.

At least 19 recordsLinked to original sources
PubMed2005

[Aberrant pancreas with a double intestinal location].

The authors report one exceptional case of aberrant pancreas with a double intestinal location (jejunum and Meckel's diverticulum) in a thirty-year-old patient. Digestive haemorrhage and the abdominal colic were the revealing clinical signs. The enteroscopy guided by the enteroscanner, was the indicated complementary investigation for the preoperative diagnosis. The research of other locations during the operation should be systematic.

Adult↗
PubMed1999

[Laparoscopic cure of gastroesophageal reflux disease. Results of a multicenter trial].

OBJECTIVES: The aim of our trial was to assess preoperative assessment and short-term results of laparoscopic cure of gastroesophageal disease performed by digestive surgeons not specialized in this disease. METHODS: 335 consecutive cures were performed by 11 surgeons. RESULTS: 29% of patients had pH-metry, 52% had manometry. The procedure was: Nissen-Rossetti in 66% of cases, Toupet in 17%, and Nissen in 16% of cases. The conversion rate was 13%. The intraoperative complication rate was 3.28% and 2.08% of patients had a reoperation. One patient died. 5% of patients had dysphagia more than three months after the operation. CONCLUSION: Our results show an absence of consensus concerning preoperative assessment. They suggest that careful intraoperative management, with a high conversion rate, reflecting our initial experience, allows similar results to those of teams specialized in laparoscopic surgery and better than laparotomy series.

Adolescent↗
PubMed1994

[Evaluation of cholecystectomy by celioscopy. Apropos of a series of 500 operated patients in a general hospital unit].

A series of 500 patients who underwent laparoscopic cholecystectomy is reported. The mean duration of the operation was 46 minutes when completed laparoscopically and 117 minutes when converted to laparotomy. The conversion rate was 10%, and the reoperation rate 2.22%. There were 5 problems related to the bile ducts (1%) including 2 lesions of the common bile duct (0.44%) with only in 21 cases. In one, a stone in the common duct was extracted laparoscopically. Mean hospitalization was 5.5 days. For us, laparoscopic cholecystectomy has become the "gold standard" for the treatment of symptomatic uncomplicated bile stone disease. Reduced hospitalization time should help reduce cost incurred due to the video surgery material.

Acute Disease↗
PubMed1994

[Value of appendectomy by celioscopy: apropos of a series of 73 cases].

The practice of coelioscopic approach in acute appendicitis is still very much debated. A study of the results of 73 patients carried out over two and half years leads one to conclude to the interest of this technique also for the treatment of appendicular peritonitis. Full exploration of the abdominal cavity, easy discovery of ectopic appendix, treatment of associated lesions, extended peritoneal washing, are the observed advantages together with reduced length of hospitalisation and few post-operative complications, in particular parietals problems and obstructions at long term. The experience of the surgeon becomes of prime importance to reduce operating time, frequency of open-surgery converting and complications.

Acute Disease↗
PubMed1992

[Cholecystectomy by celioscopy. Experience in two Upper Normandy hospital units. Apropos of 178 procedures].

Laparoscopic cholecystectomy (LC) emerges as an effective alternative to classical cholecystectomy, but its safety, benefits and indications still need to be clarified. From September 1989 to March 1991, 178 LC were performed by 8 surgeons in 2 hospitals, on 142 women and 36 men with a mean age of 48.2 years. The gall bladder wall was thin in 160 cases and thick in 18 cases (with 6 cases acute cholecystitis). We observed no deaths, 147 simple procedures with a hospital stay and drug requirement lower than with the usual cholecystectomy via laparotomy. But in 21 cases, the procedure needed a laparotomy, and in 10 cases complications occurred, requiring laparotomy in 6 cases. Our results suggest: a) LC is an improvement in the treatment of uncomplicated gallstones; b) a trained surgeon and extreme caution are required in complicated cholelithiasis; c) classical cholecystectomy is still useful in many circumstances.

Adolescent↗
PubMed1992

[Late revascularization of the renal artery: what are the prognostic criteria?].

Two patients with non functioning silent kidney on excretory urography and renal artery occlusion on angiography, underwent renal artery revascularization without severe hypertension or renal failure. Angiographic appearance of collateral circulation, histologic evidence of intact viable glomeruli and a normal sized kidney are necessary for successful results. Renal blood flow was restored in the two patients but one had slight return of function and the other patient showed no evidence of improvement. Both patients presented criteria for revascularization. The first case was a minor success on the renal scintigraphy. The return of renal function did not occur in the second case because of preexisting renal pathology. We therefore recommend histologic examination before every renal artery revascularization for chronic occlusion.

Angiography↗
PubMed1991

[The superior mesenteric artery syndrome. Apropos of a case and review of the literature].

During laparotomy for an appendicular peritonitis, the authors found an acute mesenteric artery syndrome. Conservative treatment consisted of mobilisation of the 4th part of the duodenum with section of the suspensory muscle of Treitz, but this was not sufficient to cure the patient. Two weeks later the patient completely recovered after a duodenojejunal anastomosis. A review of the literature confirmed that surgical treatment for scoliosis and anorexia nervosa play an important role in the aetiology of this disease.

Adult↗
PubMed1990

[Carney's triad: a new case associated with adrenal cortex adenoma].

Carney's triad is a combination of at least 2 of 3 tumor sites: multiple gastric leiomyoblastoma, pulmonary chondroma and paraganglioma, most often extra-adrenal and secreting. Thirty-three cases have been published; we report a new case in a 20 year-old woman, with multiple gastric leiomyoblastomas, liver metastasis, and bilateral pulmonary chondroma. The research of paraganglioma, in regard to Carney's disease, led to the discovery of corticoadrenal adenoma.

Adenoma↗
PubMed1990

[Crohn disease: results of a series of 42 intestinal resections].

Forty-two patients underwent a resection for acute or chronic complications of Crohn's disease during the years 1983-1987. The colon was involved in 38% (16 patients), the small bowel in 31% (13 patients) and the ileocaecal region in 31%. In small bowel disease, the indication for operation was either an intestinal obstruction or an internal abscess. In colonic locations, poor response to medical therapy was the indication for operation in 10 patients (63%), and an acute complication in the remaining cases. The operations performed were always "radical resections": 13 resections of small bowel, 13 ileocaecal resections, 7 ileocolectomies with ileosigmoidostomies, 6 ileocolectomies with ileorectostomies, 2 left side hemicolectomies with colorectostomies and one total coloproctectomy. There was no operative mortality. A post-operative complication occurred in two patients (4.8%). The recurrence rate was 12% after 30 months average follow up in the 34 patients with only one operation for Crohn's disease. There was no second recurrence in the 8 patients operated for a first recurrence. The factors affecting recurrence after resection were: a short pre-operative time interval since first clinical symptoms: 4.6 years versus 5.3 years without recurrence (p less than 0.01); the colonic location of the Crohn's disease (p less than 0.02). Colonic location rate of the disease was found to be higher in this study as compared to others. Since "radical resection" fails to cure all patients, surgery should be restricted to acute on chronic complications.

Adolescent↗
PubMed1989

[Digestive hemorrhage caused by rupture of esophageal varices. Analysis of 47 emergency surgeries].

Between 1 January 1984 and 31 December 1986, 47 patients out of a total of 228 patients admitted to hospital with endoscopy-proven bleeding esophageal varices, underwent an emergency operation. The indications were massive hemorrhage in 29 patients, and rebleeding early after a first serious episode in 18 patients. Four patients underwent early reoperation for recurrent variceal bleeding. Thirty-seven porto-caval shunts, 10 esophageal transections, 3 proximal gastric resections and 1 exploratory laparotomy were performed. The early results were satisfactory in 53.2% of the patients; operative morbidity and mortality were 19.1% and 27.7% respectively. Four patients died from gastric variceal bleeding soon after esophageal transection. Operative mortality was greater when the patient was Child C or operated for massive hemorrhage. Survivors were followed for at least 12 months. Two patients died from shunt occlusion and recurrent variceal bleeding. No severe encephalopathy was reported. Analysis of the results suggest that porto-caval shunt is indicated in Child A or B patients, particularly with recurrent variceal bleeding soon after a first episode controlled medically.

Adult↗
PubMed1989

[Infrahepatic hematoma secondary to gangrenous cholelithiasic hemocholecyst treated with antivitamins K].

Acute haemocholecyst is a rare disorder but often reported in patients with gallstones. Rupture of the gallbladder causing hypovolaemic shock secondary to massive intraperitoneal bleeding has been reported in about fifty patients to date. We report a new case of haemocholecyst with rupture of the gallbladder in a patient with gallstones treated by anticoagulant therapy. This case is unusual in terms of the nature of the gallbladder disease: massive gangrene with complicating hemorrhage and destruction of deficient regions of the wall of the gallbladder induced an infrahepatic haematoma without hypovolemic shock, in contrast with the massive intraperitoneal hemorrhage reported in other cases.

Aged↗
PubMed1989

[Leptospirosis caused by Leptospira icterohaemorrhagiae of the pseudo-surgical type: a case].

The authors report a case of fatal leptospirosis due to Leptospira icterohaemorrhagiae revealed by typical signs of acute cholecystitis and associated with pancreatitis in a 73 year old patient presenting with gallstones. The initial clinical findings were highly suggestive of severe but typical cholecystitis and the final diagnosis was only considered when the patient's condition worsened despite surgery, with increasing obstructive jaundice and multiple organ failure. Pancreatitis was an autopsy finding. Misleading, especially gastrointestinal symptoms are frequent in leptospirosis. Hence an early diagnosis is an essential condition for a successful antibiotic management in severe cases of leptospirosis. This possibility should be considered whenever a patient presents with infectious obstructive jaundice. The patient has to be questioned concerning possible contact with contaminated animals and, when in doubt, the presence of specific antibodies should be investigated.

Acute Disease↗