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Biomedical subjects

J F Gigot

Publications and source records attributed to J F Gigot.

At least 19 recordsLinked to original sources
PubMed1994

Laparoscopic splenectomy for idiopathic thrombocytopenic purpura.

Laparoscopic splenectomy was performed on eight patients with idiopathic thrombocytopenic purpura refractory to medical treatment. Preoperative infusion of immunoglobulin G gamma-globulin was used to boost the platelet count. Accessory spleens were sought by preoperative computed tomography and peroperative examination of the usual anatomical locations. Seven patients underwent successful laparoscopic splenectomy, with a mean postoperative stay of 3.6 days. One patient with an accessory spleen detected before operation but not during laparoscopy required conversion to open surgery for control of haemorrhage from the splenic hilum. Another patient had a transient pancreatic fistula. Laparoscopic splenectomy is feasible and sfe in patients with idiopathic thrombocytopenic purpura. Long-term results require evaluation as detection of accessory spleens can prove difficult during laparoscopy.

Adolescent↗
PubMed1994

Laparoscopic treatment of lymphoceles following kidney transplantation by intraperitoneal fenestration and omentoplasty.

The recent development of endoscopic surgery and its use in treating several abdominal and thoracic surgical pathologies lead us to suggest its application in the treatment of posttransplant lymphoceles. The authors report two cases treated by the laparoscopic approach. Recurrence occurred in one of them. The technique is described and its place among other therapeutic modalities is discussed.

Adult↗
PubMed1994

Biliary cystadenoma of the liver with elevated CA 19-9.

A case of intrahepatic biliary cystadenoma with mesenchymal stroma is reported. The tumor was associated with strikingly elevated serum and intracystic levels of the tumor-associated antigen CA19-9. Two months after surgical enucleation, serum CA 19-9 levels returned to normal.

Adenoma, Bile Duct↗
PubMed1992

[Trans-laparoscopy surgery, a passing fashion or progress?].

Since the first laparoscopic cholecystectomy performed in 1987 by Philippe Mouret in Lyon (France), there has been a real revolution in the field of visceral surgery: more and more operations are performed by this mini-invasive surgical method: lithiasis of the common bile duct, Nissen and Heller procedure, truncal vagotomies, abdominal and thoracic, supra-selective vagotomies, hernia, appendectomy, band sections during intestinal occlusion, resection of the colon and rectum, oesophagectomies ... In Belgium, more than 3,000 cholecystectomies have been listed in a national registry in which the modalities and complications of this laparoscopic approach have been scrutinized. During the years to come, there will be an important technological development which will make this procedure easier, safer and quicker. Consequences of this new approach cannot completely be foreseen but there are some drawbacks: possible simplification of well established surgical techniques in order to facilitate the laparoscopic approach, causing a deterioration of the long term results, teaching and training difficulties for young and older surgeons, very costly equipment.

Cholecystectomy, Laparoscopic↗
PubMed1992

[Contribution of surgical endoscopy and extrahydraulic lithotripsy in complex biliopancreatic lithiasis].

Surgical endoscopy combined with electro-hydraulic lithotripsy was done on 17 patients selected for complex multiple bilio-pancreatic lithiasis. In the biliary tract (7 patients), per operatory lithotripsy was performed on 3 patients (impacted main duct stones n = 2, impacted left hepatic stones n = 1); it was done through a T-tube in 1 young patient with an impacted stone in the ampulla and percutaneously in 3 patients (1 gall bladder and 2 intra hepatic lithiasis, one of them with biliary cirrhosis and portal hypertension). Four of this patients had had iterative surgery, extracorporeal lithotripsy or retrograde endoscopy. Complete desobstruction was obtained in all patients with minimal morbidity (minor hemobilia n = 2, hemorrhage from oesophageal varicose n = 1). In the pancreas, the technique was performed on 10 patients with impacted stones in the Wirsung duct and cephalic obstruction. Mean duct diameter was 7 mm. Complete desobstruction was obtained in 9 cases and endoscopic maneuvers were associated with "double stream" operation: sphincterotomy and cephalic desobstruction plus latero-lateral wirsungo-jejunostomy. Morbidity was small (minor hemorrhage n = 3). To conclude, endoluminal electro-hydraulic lithotripsy is an interesting adjuvant technique for the treatment of obstruction from stones in complex bilio-pancreatic lithiasis, either during open surgery or trans-cutaneously.

Adult↗
PubMed1991

[Type I neurofibromatosis (von Recklinghausen's disease) associated with abdominal neurofibrosarcoma and pheochromocytoma. Apropos of a case].

Neoplasia and endocrine disorders are common complications of neurofibromatosis 1 (NF1--von Recklinghausen disease). We report here a case of NF1 in a 31-year-old woman presenting simultaneously with an abdominal neurofibrosarcoma and a pheochromocytoma. The prevalence of secondary neoplasia and endocrine tumors in NF1 is also discussed.

Abdominal Neoplasms↗
PubMed1991

[Treatment of hepatic metastases by surgical excision].

Surgical resection of hepatic metastases is mainly performed for colo-rectal carcinomas. The natural history of these metastases shows that their course is variable but death of the patients occurs within one year after discovery of obvious hepatic metastases in 50% of these patients. Five years survival after complete surgical hepatic resection is reported to be around 20% in most series. Prognosis is determined by the node involvement of the primary tumour, the degree of local invasion (Dukes classification) and the time of appearance of the liver-metastases (metachronous or synchronous). A better pre- and intra-operative (ultrasound) detection could improve these results.

Humans↗
PubMed1990

Nontumorous attenuation differences on computed tomographic portography.

Nineteen patients with suspected hepatic neoplasms underwent dynamic computed tomography (CT) and computed tomographic porotography (CTP) in a preoperative setting. Nontumorous attenuation differences in the liver were observed in 8 patients (42%) with CTP and in 2 patients (10.5%) with dynamic CT (p less than 0.05). Although nontumorous attenuation differences are significantly more frequent with CTP than with dynamic CT, they are seldom a diagnostic problem because of their geographic pattern.

Adult↗
PubMed1990

Dynamic spin-echo imaging with Gd-DTPA: value in the differentiation of hepatic tumors.

Thirty patients with hemangiomas (n = 6), benign liver cell tumors (n = 7), and primary or metastatic malignant tumors of the liver (n = 17) underwent dynamic MR imaging with Gd-DTPA to determine the value of the procedure in the differentiation of hepatic tumors. The diagnoses were proved by histology or follow-up. Hemangiomas had a significantly greater mean T2 value (192.1 +/- 34.8 msec) than did both benign liver cell tumors (71.9 +/- 16.9 msec; p less than .01) and primary or metastatic malignant tumors (79.7 +/- 21.2 msec; p less than .01), but the T2 values of benign liver cell tumors and malignant tumors were not significantly different. Both hemangiomas and benign liver cell tumors had a significantly greater mean signal-intensity ratio (1.86 +/- 0.60 and 1.77 +/- 0.26, respectively) than did malignant tumors (1.04 +/- 0.34; p less than .01) in the early phase after Gd-DTPA administration, and hemangiomas had a significantly greater signal-intensity ratio (1.59 +/- 0.21) than did both benign liver cell tumors (1.21 +/- 0.08; p less than .01) and malignant tumors (1.06 +/- 0.26; p less than .01) in the delayed phase. These results suggest that dynamic MR images obtained after administration of Gd-DTPA are useful in differentiating hepatic hemangiomas, benign liver cell tumors, and malignant liver lesions.

Adenoma, Bile Duct↗
PubMed1989

Acute cholangitis. Multivariate analysis of risk factors.

In order to identify risk factors in patients with acute cholangitis, 140 clinical, biochemical, etiologic, and pathologic variables of 449 attacks of acute cholangitis seen in one center over a 20-year period were analyzed. Simple regression revealed 24 factors with prognostic significance, but multivariate analysis detected only seven factors with independent significance in predicting mortality (acute renal failure, cholangitis associated with liver abscesses or liver cirrhosis, cholangitis secondary to high malignant biliary strictures or after percutaneous transhepatic cholangiography, female gender, and age). When the presence of each of these factors is weighted proportional to its coefficient of regression, patients with cholangitis could be scored on a scale of 0-27. A score of seven was clinically the most useful cut off--388 attacks of cholangitis associated with a score of less than 7 had a mortality rate of only 1.8%, whereas 61 attacks associated with a score greater than or equal to 7 had a mortality rate of 49%. The value of this scoring system needs to be confirmed in prospective studies, but it may prove useful, for example, in selecting a group of high-risk patients for urgent biliary decompression in an attempt to reduce the mortality associated with this pathology.

Acute Disease↗
PubMed1988

[Performance of endorectal echography in tumors of the rectum].

From November 1986 to December 1987, endorectal ultrasound (EUS) has been performed 57 times in a total of 54 patients. In the cancers of the low and mid rectum (n = 34), the extent of the tumoral infiltration was accurately assessed by preoperative EUS in 88% of cases. Sensitivity of tumor spread beyond the rectal wall was 0.96. Classification of lymph nodes was more hazardous. The muscular layer was intact in 5 villous adenomas. The diagnosis was difficult in the case of a huge and massively secreting tumour. In the follow-up of the patients after rectal resection(n = 11) or local excision (n = 3) for cancer, EUS allowed an accurate analysis of the suture line in 12 cases. Three submucosal recurrences were detected. The follow-up showed no recurrence in the other cases with a tumor-free suture line pattern. The literature confirms that EUS is a non invasive, efficient and inexpensive method in the preoperative staging of non stenotic rectal tumors. The problem of accuracy of lymph node staging has not been resolved. The technique shows some promise in detecting local recurrences.

Adenocarcinoma↗
PubMed1986

[Detection of thyroid cancer : utopia or reality? Or the value of thallium 201 in thyroid pathology].

Faced with a diagnosis of cold thyroid nodule as evidenced by routine scintigraphy, the clinician has to determine whether this nodule is malignant or not. This is a serious problem since, according to literature, 7-20% of cold thyroid nodules are malignant. In 1982 some Japanese authors demonstrated the possibility of using 201 T1 in diagnosing thyroid tumors. This study refers to 120 patients who underwent an operation for thyroid disorders characterized by the presence of one or several cold nodules (as evaluated with conventional scintigraphy) and enables a comparison between a thorough evaluation of the thyroidal status and the 201 T1 scintigrams. These were obtained with a gamma-camera using a pinhole collimator. If a cold nodule is positive with 201 T1, surgery is incontestably indicated, as such a finding correlates with the existence of a thyroid tumor (benign follicular adenoma or carcinoma) in 89.5% of the observed cases. In the cancer group the sensibility of the Thallium test is of 85% and its specificity 80%. We may assert that there is a very low risk of Thallium negative (old) nodules being malignant. The pre-operative 201 T1 scintigraphy is easy to perform in any Nuclear Medicine department. Nowadays, the combination of aspiration cytology and 201 T1 scintigraphy should make it possible to make and accurate diagnosis in the vast majority of differentiated and undifferentiated thyroid cancers.

Adenoma↗