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D Benchimol

Publications and source records attributed to D Benchimol.

96 records · Page 6Linked to original sources
PubMedDate not supplied

Infectious complications of endoscopic retrograde cholangio-pancreatography managed in a surgical unit.

The immediate infectious pancreato-biliary complications of endoscopic retrograde cholangiopancreatography (ERCP) warranting transfer to a surgical unit are analyzed, in order to evaluate their frequency and severity as well as means of treatment and prevention. Thirty complications of this type were observed in a series of 3226 ERCP performed with or without endoscopic sphincterotomy (ES) over a six year period (0.9%). ES had been performed in 12 of 30 cases, but the complication could not be attributed to the procedure. Post-ERCP complications included: acute cholangitis: 16 cases (53%); acute cholecystitis: 8 cases (26%); acute pancreatitis: 4 cases (13%); infected pancreatic pseudocyst: 2 cases (6%). The global mortality rate was 16.6% (five patients): Four of the deaths were due to septic complications. Twenty-seven of the 30 patients underwent surgery, and three of them died (11%). Acute cholangitis was responsible for most of the deaths (four of five) and the mortality appeared related to the long interval before surgery (three of four deaths). Strict adherence to good endoscopic procedures (aseptic conditions, injection without excessive pressure, antibiotic prophylaxis) and decompression of the biliary tract (nasobiliary drain or transhepatic catheter) should help reduce the frequency of post-ERCP complications, and especially cholangitis, which appears to benefit from early surgical treatment.

Acute Disease↗
PubMedDate not supplied

[Conservative treatment of epidermoid cancer of the anal canal combining radiotherapy and curietherapy. Experience at the Antoine-Lacassagne Center].

From 1973 to 1987, 33 patients aged from 46 to 86 years (25 female, 8 male) were treated for a tumour of the anal canal with radiotherapy and curietherapy. Tumour distribution was 7 T1, 19 T2, 7 T3, and 4 patients were N+. After treatment it was possible to assess 31 patients; 29 were in complete remission, remission was obtained in 2 others following surgery. Tolerance was comparable to other series but 4 patients developed necrosis of the anal canal; 2 patients died under general anesthesia and 1 patient had a radiation injury of the small intestine. The sphincter was conserved in 65 p. cent of cases. Relapse occurred in 8 patients within 6-92 months, and 6 patients developed metastases. Overall survival was 78 p. cent at 3 years and 74 p. cent at 5 and 10 years. Disease-free survival was 65 p. cent at 3 and 5 years and 52 p. cent at 10 years. Our results confirm those of other series using a similar treatment plan. This treatment is difficult to put into practice. Patients must be carefully selected preferably by a team including proctologist, surgeon and radiotherapist.

Aged↗
PubMedDate not supplied

[Tumor markers in the follow-up of colorectal cancers].

The aim of this work was to review the usefulness of tumour markers in the follow-up of colo-rectal cancers after operation. The carcinoembryonic antigen (CAE) is the most sensitive marker for early detection of relapse. It can be combined with CA 19-9 assay, increasing the sensitivity and specificity of the tests. These assays are useful because one half of the relapsing tumours can be resected leading to a survival rate of 40%. CAE and CA 19-9 must be assayed within 2 months to 2 years after surgery to be effective screening tests. Presently, the widespread use of labelled monoclonal antibodies can, in certain tests, localize recurrent tumours before a second look operations.

Antibodies, Monoclonal↗
PubMedDate not supplied

[Neuroma of the common bile duct].

After a surgical operation on the biliary tract, stenoses can occur, most of the time due to fibrotic lesions, and more rarely due to granulomas or traumatic neuromas. The latter generally develop on the cystic stump after a cholecystectomy. The occurrence of a traumatic neuroma on the common bile duct is much more rarely described. We report the case of a 64 year-old man presenting, four years after a surgical removal of the gallbladder, with a cholangitis, due to neuroma located on the choledochus. He was treated by surgical resection of the common bile-duct at the site of the stenotic zone, and choledocojejunal anastomosis; post-operative course was satisfactory.

Cholangitis↗
PubMedDate not supplied

[Prognostic factors in colorectal adenocarcinoma].

Aim of this study was to analyse prognostic factors of improved survival after resection of colorectal cancer. We studied 715 patients by retrospective review operated for colorectal adenocarcinoma. Survival was analyzed by the Kaplan-Maier method. Comparisons were made by log rank analysis. The overall survival is 75% at 1 years, 41.0% at 5 years, 29.7% at 10 years. A significant difference was noted in the survival rate according to age of the patients (p < 0.01), preoperative serum level of carcinoembryonic antigen (CEA) (p < 0.05), the performance status (p < 0.05), intestinal obstruction (p < 0.01), clinicopathological stage of the tumour (p < 0.05). Other factors including the sex, the clinical diagnosis of anaemia, the site of the tumour and histological grade had no apparent influence on survival. To define high-risk groups of recurrence is important for adjuvant therapy and follow-up study.

Adenocarcinoma↗