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Biomedical subjects

J M Chevallier

Publications and source records attributed to J M Chevallier.

At least 109 records · Page 6Linked to original sources
PubMed1987

[Truncal vagotomy in the posterior inframediastinal space by abdominal approach with suprahiatal phrenotomy].

A proposed procedure for truncal vagotomy uses an abdominal approach with a short posterior phrenotomy above the hiatal orifice. A gastric emptying operation is obviously combined. The aim is to avoid exposing the abdominal esophagus in case of postoperative symphysis or when it is preferable to avoid altering normal morphology and functioning of the esophago-cardio-tuberosital junction. This procedure can be useful in certain particular cases to perform vagotomy in the posterior infra-mediastinal space.

Humans↗
PubMed1986

[The hepaticocaval intersection: current anatomosurgical aspects. Apropos of 32 dissections].

Segmental occlusive phlebography of IVC coupled with a slit in its posterior wall, injection of corrosive substances into portal and hepaticocaval network, biometry of the retrohepatic IVC and serial sections of injected livers from 32 fresh subjects has allowed definition of the hepaticocaval intersection which constitutes one of the rare current stumbling-blocks to hepatic surgery. Emergency surgery for hepaticocaval injuries exposes patients to the risk of gas embolus and massive haemorrhage. Using a median sternolaparotomy approach they require previous temporary hemostasis by quadruple clamping or intracaval shunt: in more than half of cases the length of the subhepatic, suprarenal IVC of less than 1 cm does not permit application of a clamp and necessitates introduction of an intracaval shunt by the atrial route. Cold surgery for certain hepatic tumors close to the intersection can benefit from vascular exclusion of liver but the right middle capsular and inferior phrenic veins must be clamped: clamping of the suprahepatic IVC is dependent on the site of the intersection in relation to diaphragm. The principal right hepatic vein, lacking collateral over 1 cm external to liver in 1 of 2 cases, can be controlled extraparenchymatously after mobilization of right liver, but caution is needed because of the predominance of "accessory" hepatic veins in 25% of cases. Control of hepatic veins external to liver on left side is dangerous since a common trunk is frequent (87.5%), collateral branches numerous and often vulnerable. Relations between intersection, diaphragm and right atrium also define modalities of treatment of hepatic lesions in membranes of terminal IVC and in Budd Chiari's syndrome.

Aged↗