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D A Gervais

Publications and source records attributed to D A Gervais.

22 records · Page 2Linked to original sources
PubMedDate not supplied

Complications after pancreatoduodenectomy: imaging and imaging-guided interventional procedures.

Over the past decade, performance of the Whipple procedure, or pancreatoduodenectomy, to treat both malignant and benign disease has increased. This increase is in large part due to the decreasing perioperative mortality rate, which is down from historic highs of 25% to the 1.0%--1.5% now achieved in large centers. Although advances in surgical management have improved the outlook for patients undergoing pancreatoduodenectomy, the improving mortality rate is also in part attributed to improvements over the past 2 decades in cross-sectional imaging and imaging-guided interventional procedures. Although the mortality rates have improved, the morbidity, or rate of complications, has remained relatively constant. Contributions by radiologists in both diagnosis and treatment of complications are crucial in certain patients with postpancreatoduodenectomy abdominal abscesses, bilomas, liver abscess, and biliary obstruction. Familiarity with normal variations in the postoperative appearance of the upper abdomen, awareness of pitfalls in interpretation, and knowledge of the available imaging-guided interventions will facilitate recognition of postpancreatoduodenectomy complications and allow prompt triage of patients to imaging-guided interventions.

Humans↗
PubMedDate not supplied

Transvaginal interventional procedures: aspiration, biopsy, and catheter drainage.

Transvaginal ultrasonographically (US) guided procedures are simple and safe and often represent the only means of access to pelvic disease. Aspiration of cystic pelvic masses and core biopsy of solid pelvic masses can be easily performed by using the transvaginal route, an endoluminal US transducer, and a needle guide. Because of concerns about false-negative diagnosis and potential tumor seeding with biopsy of primary ovarian cystic lesions, the indications for transvaginal aspiration and biopsy of ovarian and adnexal lesions are predominantly therapeutic. Similarly, using an endoluminal probe with modification of the guide, one can also perform safe and effective trocar catheter drainage of pelvic abscesses via the transvaginal route. The transvaginal route is ideally suited to pelvic abscess drainage because of the proximity of the vaginal fornices to most pelvic fluid collections. The transvaginal route has the disadvantage of being semisterile; because of the risk of superinfecting previously noninfected pelvic pathologic conditions, the transvaginal approach should be used only for solid lesions or cystic lesions that can be completely aspirated. Familiarity with the transvaginal route of access is crucial for adequate treatment of many gynecologic and nongynecologic pelvic pathologic conditions.

Adult↗