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Biomedical subjects

H Lapeyrie

Publications and source records attributed to H Lapeyrie.

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↗
PubMed1993

[Lipoblastoma of the omentum].

The authors report on a case of benign lipoblastoma of the omentum in a two year-old child. It was discovered following systematic examination and was treated by surgical excision.

Child, Preschool↗
PubMed1990

[Pyloric stenosis with rare etiology].

The authors report on a 30 month-old boy who experienced pyloric stenosis related to an hamartoma. This case shows the difficulties in such a clinical and histological diagnosis.

Child, Preschool↗
PubMed1989

[Non-functional or silent endocrine tumors of the pancreas. Apropos of a case of cystic form].

The authors report a new case of silent cystic pancreatic endocrine tumour discovered by chance on abdominal ultrasonography. This tumour was treated surgically by simple enucleation-resection. On the basis of the histological appearance and the absence of metastases, this tumour was considered to be benign, but only the long-term course will confirm the diagnosis.

Diagnosis, Differential↗
PubMed1989

[Duodenopancreatic contusions. Diagnostic difficulties in children].

The authors describe a case of duodenopancreatic injury in a 6-year-old girl, with the clinical presentation of appendicitis. The findings point to the importance of a precise anamnesis, as in its mild form the traumatism is often poorly recognized, and may be incorrectly diagnosed. It is therefore recommended that a thorough clinical examination be carried out, with abdominal ultrasonography, X-ray barium and tomodensitometry if necessary. Frequently, as is the case with other abdominal, injuries, surgery may be avoided if the patient's condition is carefully followed.

Child↗
PubMed1989

[Appendiceal mucoceles. Apropos of 2 cases].

Most often called muco-secreting tumors, the mucocele of the appendix are rare (0.2 to 0.3% of appendicectomies). The clinical signs are not specific; ultrasonography and scannography would contribute to diagnosis. The pathogenis is not known yet. The benign forms are cured by appendicectomy. The malignant forms still have a bad prognosis.

Aged↗
PubMed1988

[Giant diverticulum of the transverse colon].

A complication of colonic diverticulosis, giant diverticula are seen above all in the sigmoid region. On the basis of a case involving the transverse colon, the authors stress the clinical and ultrasonographic pseudo-tumoural symptomatology as well as the degree of superinfection of the contents. Anatomical arguments would be in favour of pathogenesis by progressive increase in size of an ordinary diverticulum rather than by perforation with secondary encystment. Excision of the diverticulum required segmental colectomy.

Colectomy↗
PubMed1987

[Torsion of the ovary in children: value of echography and difficulties of anatomical interpretation].

Two cases with the clinical presentation of peritonitis and a 9 year-old girl with ovarian torsion are reported: a 2 year-old girl with paroxistic abdominal pain and occlusive syndrome. Ultrasonography was of main interest in that situation. The necrotized ovary was extracted at intervention in both cases; histological data did not allow to distinguish the torsion on an hemangiomatous ovary from the torsion of an healthy ovary, which represents an exceptional feature.

Child↗