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B Deixonne

Publications and source records attributed to B Deixonne.

At least 19 recordsLinked to original sources
PubMed1995

[Bilateral splanchnicectomy by transhiatal approach in pain of pancreatic origin. 37 cases].

OBJECTIVES: Surgical splanchnicectomy remains a useful means to relieve pain induced by malignant tumours of the pancreas and chronic pancreatitis. We report our experience in 37 patients. METHODS: Between 1983 and 1993, 37 patients underwent transhiatal bilateral splanchnicectomy; 32 had a non-resectable adenocarcinoma and 5 chronic pancreatitis. In all cases, morphine had been required for pain relief. RESULTS: Symptomatic pain relief was immediately achieved, with complete sedation in 84.3% of the cases. Prolonged antalgic effect continued for the survival period in 84.3%. Mean post-operative follow-up was 12.7 weeks corresponding to mean survival in 32 patients with pancreatic tumour. Post-operative mortality was 21.6% with no direct relationship with neurectomy. Specific morbidity related to pleural drainage was 10.8%. CONCLUSION: Compared with other surgical procedures, trans-hiatal bilateral splanchnicectomy is a simple technique which can be performed whatever the stage of the locoregional tumour extension. In patients without an indication for exploratory laparoscopy, percutaneous chemical neurolysis is still indicated, even if the long-term result is less effective. In case of failure or technical impossibilities, thoracoscopic splanchnicectomy should be performed.

Abdominal Pain↗
PubMed1994

[Preliminary study of the feasibility of intraoperative ultrasonography of the biliary tract during cholecystectomy under celioscopy].

Peroperative echography and cholangiography provide similar information during the exploration of the biliary tree for conventional surgery for gall stones. Peroperative cholangiography is more difficult to perform via the coeolioscope with a failure rate of 10% in the most skillful teams. We investigated the technical feasibility of peroperative echography during coeliosurgery for gall stones. The technique was performed in 13 patients using a pulsed Doppler 7.5 MHz scan laparoscope. The entire biliary tree was successfully imaged in 12 patients and the three structures of the hepatic pedicle were identified in all cases. The exploration took less than 10 minutes and there was no morbidity. One gall stone was discovered and endoscopic sphincterotomy was performed immediately. None of the patients presented signs suggesting residual lithiasis with a mean follow-up of 2 months. This preliminary study suggests that the technique is very favourably feasible and may play an important role in the exploration of the bile tract during coelioscopic cholecystectomy.

Adult↗
PubMed1991

[EC-cell pancreatic endocrine carcinoma responsible for chronic diarrhea].

Ec cell or carcinoid enterochromaffinomas are very rare among the endocrine tumors, and more specifically orthocrine tumors, of the pancreas. We report one case of primary malignant carcinoid tumor of the pancreas, with no apparent metastasis, discovered during exploration for chronic diarrhea associated with hypercalcemia, disorders of carbohydrate metabolism and a serotonin secretion. The treatment consisted in a left splenopancreatectomy associated with a left adrenectomy. The clinical and biological signs immediately disappeared and, after a time lapse of almost five years, the general condition of this patient is quite satisfactory.

Acidosis↗
PubMed1989

Small carcinomas of the pancreas with associated chronic pancreatitis: two case reports.

Two cases of pancreatitis associated with papillary atypical hyperplastic lesions and micro-invasive cancers are reported. They are interesting from an etiopathogenic and diagnostic point of view by again illustrating the problem of transmission between hyperplastic lesions and cancer, together with the difficulties encountered in asserting the certainty of diagnosis. In each observation the association of pancreatic lesions, of all stages of hyperplasia, and of cancer can be observed. This suggests that transmission occurs between those different lesions. In such cases diagnosis of benignity or malignancy is always difficult to assert. No clinical, biological, morphological or even cytological criterion allows one to make a ruling. For this reason excision is recommended by the authors whenever the etiology of pancreatitis remains obscure and especially in the presence of important dystrophic lesions.

Adenocarcinoma↗
PubMed1989

[Prognostic factors of surgically-treated cancers of the right colon. Multifactorial analysis of a series of 50 curative excisions].

Between 1970 and 1986, 502 colorectal cancers were operated in our department. In 82 cases, it was located on the right, including 50 patients who underwent curative right hemicolectomy. Overall, at 5 years, 23 patients are alive with no recurrence (46%), 17 died from their cancer (34%) and 10 patients died of intercurrent causes (20%). Among the 13 prognostic factors analyzed, only the pathologic stage of the tumor (extend of dissemination to the abdominal wall and lymph nodes) and preoperative fever had a statistically significant effect on 5 year survival (p = 0.001 for fever and p = 0.01 for Duke's stage). The multifactor analysis clearly delineates a group with a poor prognosis (group with lymph node involvement and fever) in which the median of survival was 30 months.

Aged↗
PubMed1988

[Pancreatic insulinoma. Peroperative topographical diagnosis].

Difficult problems may arise and place the surgeon in an uncomfortable position in cases where neither pre-operative investigations nor palpation of the pancreas have enabled pancreatic insulinomas to be localized. However, 3 examinations performed during the operation should help solve these problems, as shown by the case presented here. These examinations are insulin assays in the peripancreatic venous blood, blood glucose measurements under constant rate glucose infusion, and intra-operative ultrasonography. Pre-operative radioimmunological assays of insulin have been used for about 10 years, but owing to technical advances and shortening of the incubation time these assays can now be performed during surgery and, above all, with immediate results. Blood glucose measurements are good pointers, and this method has long been used in this type of surgery. Intra-operative ultrasonography has recently been introduced; it is very effective in diagnosing endocrine tumours of the pancreas, since the images it provides are quite characteristic. These 3 examinations combined should be used to localize pancreatic insulinomas; they may replace most of the pre-operative examinations that are still carried out.

Adenoma, Islet Cell↗
PubMed1988

[A case of peritonitis due to perforation of the small intestines of tubercular etiology. Review of the literature].

The perforation into free peritoneum is a singular complication of the intestinal tuberculosis. Regarding a recent observation of this complication revealing small intestinal tuberculosis, we have tried to make the point on this exceptional form of small intestinal tuberculosis. By means of prolonged enteric nutrition and antitubercular treatment, the patient will be cured of this disease without any after-effects as we mentioned it in our observation. Very fearsome in the past (44 deaths out of 104 published cases), perforation into free peritoneum nowadays has a better prognosis.

Humans↗
PubMed1988

[A Technic of re-using a thrombosed hepatic artery in hepatic intra-arterial chemotherapy].

Nowadays the palliative treatment of hepatic metastasis very often uses the hepatic arterial chemotherapy in subcutaneous injection cavity. Unfortunately in about ten per cent of the cases, the thrombosis of hepatic artery limits the lasting quality of use of the catheters which last about twelve months (more or less four). As mentioned in our observation, if the patient "answers" the chemotherapy, we propose reusing this thrombosized artery by means of an original technical artifice. In this observation, in fact, we grafted a small segment of submesenteric vein on the hepatic disobstructed artery. We think that this artifice could also be used in case of anatomic variations of the hepatic artery like trifurcation.

Aged↗
PubMed1987

[Congenital diverticulum of the bile ducts. Apropos of a case and review of the literature].

The authors report a case of Congenital Diverticulum of the common bile duct treated by surgery. Literature reviews are giving detailed reports on this rare affection which falls within the scope of Congenital Diverticulum of the common bile duct, it has only a small share in this report. The comments relate the anatomic, pathogenic, diagnostic and evolutive data. The treatment appears to be possible in any case: surgical exeresis of the diverticulum.

Common Bile Duct Diseases↗
PubMed1987

[Lymph node-hepatosplenic hemangioma in an adult with consumption coagulopathy and fatal cardiac insufficiency].

Hemangioendothelioma is seldom seen in adults. Its severe evolution is due, not so much to the exceptional transformation into hemangiosarcoma, but mainly to haemorrhagic complications by rupture or consumption coagulopathy and to severe cardiac insuffficiency secondary to arteriovenous shunts. The case reported here concerns a 64 year-old woman presenting pain in the left hypochondrium and splenomegaly. A splenectomy was performed and the histological findings were compatible with the diagnosis of hepato-splenoganglionic hemangioendothelioma. The evolution was unfavorable. The patient died a few months later in a picture of haemorrhagic syndrome and cardiac insufficiency. Histological findings on autopsy specimens indicated a cavernous hemangioma. The treatment of these diffuse hemangiomas is a difficult one. Hepatic artery ligation has been advocated in certain desperate situations. Nevertheless, because of a collateral circulation, recurrences are frequent.

Diagnosis, Differential↗
PubMed1985

[Localized intestinal lymphangiectases presenting as peritonitis].

The authors report a case of localised intestinal lymphangiectases in a segment of jejunum with the unusual presentation of an acute perforation. The anatomical findings did not provide a satisfactory aetiopathogenic explanation, although the most likely hypothesis is a past history of abdominal irradiation. The mechanism of the perforation also remains unclear and the presence of microscopic lesions in the wall of the remaining small intestine raises the problem of the long-term prognosis.

Adult↗