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Biomedical subjects

J P Lambilliotte

Publications and source records attributed to J P Lambilliotte.

At least 19 recordsLinked to original sources
PubMed1998

Contribution of computed tomography to decision making in the management of adhesive small bowel obstruction.

BACKGROUND: In adhesive small bowel obstruction, the early recognition of complications such as strangulation or volvulus is essential to choose between surgical or conservative initial treatment. The objective of this study was to determine prospectively the contribution of computed tomography (CT) to decision making in the management of these patients. METHODS: Patients with suspected adhesive small bowel obstruction had CT at admission. Patients with CT signs of volvulus or strangulation and/or clinical signs of peritoneal irritation underwent urgent surgery; other patients had conservative initial treatment. RESULTS: Fifty-four patients were evaluated. CT demonstrated signs of strangulation or volvulus in 19 patients, including three with signs of peritoneal irritation. Within this group, urgent laparotomy was performed in 17 patients and confirmed the CT diagnosis in 16. Thirty-seven patients without clinical or CT signs of complications had initial conservative treatment; among them, seven of 12 with a distal obstruction determined by CT required a delayed operation for persisting obstruction, compared with two of 25 patients with a proximal obstruction (P < 0.01). CONCLUSION: CT is useful for the evaluation of adhesive small bowel obstruction, to detect accurately patients with complications who require urgent operation and to determine the location of the adhesion, which represents a significant prognostic factor for success of conservative treatment.

Adult↗
PubMed1995

[Cholestatic hepatitis and amoxicillin-clavulanic acid combination. Personnel case report and literature review].

The association amoxicillin-clavulanic acid is a widely used medication. Only about 15 cases of cholestatic hepatitis were reported in Belgium between 1990 and 1993; about 100 cases have been reported to the pharmaceutical company. This effect is severe but reversible. The injury is probably idiosyncratic or immunologically based. Age, sex and treatment duration are as many agents of risk. The diagnosis is undertaken on basis of clinical examination, chronological study, biological evolution and histology.

Age Factors↗
PubMed1992

Computerized morphonuclear characteristics and DNA content of adenocarcinoma of the pancreas, chronic pancreatitis, and normal tissues: relationship with histopathologic grading.

We report the morphonuclear characteristics of normal (13 cases), benign (ie, chronic) pancreatitis (six cases), and neoplastic (ie, ductal) adenocarcinoma (22 cases) tissues of the pancreas. This description is based on computerized cell image analysis, which permits the determination of parameters related to the morphometric (nuclear area), densitometric (nuclear DNA content), and chromatin texture features of Feulgen-stained nuclei from paraffin-embedded archival material. We observed that nuclear area discriminates between normal and benign (ie, chronic pancreatitis) as opposed to neoplastic cell nuclei. Morphonuclear parameters describing chromatin pattern characteristics made it possible to discriminate between grade I pancreatic carcinoma and normal and benign cell nuclei on the one hand, and grades I and III carcinoma on the other hand. The nuclear DNA content increased in a continuous manner from normal and benign through low-grade to high-grade neoplastic tissues of the pancreas. Combining the morphometric, densitometric, and textural parameters into one equation, we were able to calculate a score (ie, the malignancy level index) that showed a close relationship to conventional histopathologic grading. Thus, the computer-aided diagnosis of cytologic specimens from pancreatic lesions offers information of the same significance as that obtained by conventional histopathologic grading.

Adenocarcinoma↗
PubMed1991

Intraductal mucin-hypersecreting neoplasms of the pancreas. A clinicopathologic study of eight patients.

Intraductal mucin-hypersecreting neoplasms of the pancreas with extreme dilatation of the main duct were studied in eight patients. They included five men and three women, aged 47-85 years. Five patients had a history of symptoms mimicking pancreatitis; four developed steatorrhea and/or diabetes. At endoscopic retrograde pancreatography, five patients showed an open ampulla filled with mucin, and six patients showed patchy filling defects in the ectatic main duct. Morphological examination showed extreme dilatation of the entire pancreatic duct in six patients and its tail segment in two patients. The duct segments filled with viscous mucin were lined by well-differentiated mucin-secreting cells, forming papillary foldings and occasionally showing cellular atypia. None of the patients had invasive tumor or metastasis. Six patients whose lesions were resected are alive and doing well (mean follow-up, 5.5 years). It is concluded that intraductal mucin-hypersecreting neoplasm is a pancreatic tumor with favorable prognosis. Because it shares many features with intraductal papillary neoplasm, a common pathogenesis of these pancreatic tumors is suggested.

Adenocarcinoma, Mucinous↗
PubMed1990

Use of somatostatin for complications occurring after liver transplantation.

Somatostatin can be helpful after liver transplantation in some well-defined indications. In uncontrolled digestive haemorrhage, a short course of somatostatin therapy can be of great help in controlling the acute bleeding and to avoid emergency laparotomy. Somatostatin could also be helpful in bilio-pancreato-intestinal fistula, but in this case its advantage over elective surgical treatment remains to be confirmed.

Acyclovir↗
PubMed1990

Liver transplantation for fulminant and subacute viral hepatic failure in adults.

In our early experience, orthotopic liver transplantation was found to be successful in fulminant and subacute hepatic failure due to viral hepatitis in adults, with 66% 1-year survival rate. In the future, more accurate prognostic criteria would probably improve overall survival rate in acute hepatic failure, by allowing better and earlier selection of patients requiring liver transplantation.

Adult↗
PubMed1989

Epithelioid hemangioendothelioma of the liver following contact with vinyl chloride. Recurrence after orthotopic liver transplantation.

Malignant epithelioid hemangioendothelioma of the liver is a recently recognized and uncommon neoplasm of vascular origin. Few cases have been reported and the treatment remains therefore difficult to define. A relationship to oral contraceptive use has been suggested but no other toxic agents have been incriminated. We report here the first case occurring after a close contact with vinyl chloride. Because of wide hepatic destruction and serious portal hypertension with bleeding varices, the patient underwent orthotopic liver transplantation. After a disease-free interval of 20 months, he died from variceal hemorrhage and encephalopathy due to local tumor recurrence with portal thrombosis. Nevertheless, orthotopic liver transplantation remains the only hope of salvage when extensive liver destruction and life-threatening complications are present.

Adult↗
PubMed1989

[Parenteral nutrition at home: 2 years' experience].

Home parenteral nutrition (HPN) must be reserved for patients with an dysfunctional bowel requiring a long-term nutritional support. We report a 2 year experience of HPN at Erasmus Hospital which includes seven patients. Indications and implications of HPN are also discussed.

Crohn Disease↗
PubMed1989

Pancreaticoduodenal resection for pancreatic or periampullary tumors--a ten-year experience.

Between January 1978, and December 1987, 79 patients underwent pancreaticoduodenal resection for pancreatic (44) or periampullary tumors (ampulla 18, common bile duct 9, duodenum 8). Fifty-five patients were icteric (55/79: 70%); 33 of them underwent preoperative biliary decompression (endoscopic procedures 29, percutaneous transhepatic drainage 3, laparotomy and T-tube placement. 1) After biliary drainage, bilirubin levels decreased from 12.4 +/- 1.3 mg/dl at admission to 5.1 +/- 1.1 mg/dl before surgery. Pancreaticoduodenal resection was performed within a mean of 15 +/- 13 days after biliary decompression. Twenty-seven patients had no complications, others developed one or more complications. The postoperative mortality was 5% (4/79). The influence of various clinical, biological and pathological factors on postoperative complications and long-term survival was studied. Neither jaundice nor preoperative biliary drainage had a statistically significant effect on overall morbidity and mortality. However, septic and hemorrhagic complications appeared to be more frequent with preoperative bilirubin levels above 20 mg/dl (0.05 less than P less than 0.1), while all postoperative pancreatic and biliary fistulas occurred in patients with a bilirubin level below 6 mg/dl (P less than 0.01). Biliary fistulas were also more frequent when anastomosis was performed on a non-dilated biliary duct (P less than 0.05). Overall actuarial survival was 58% at 1 year and 26% at 5 years. Node and/or contiguous tissue infiltration significantly decreased long-term survival (P less than 0.001). Seventy-one adenocarcinomas were reviewed and graded following a modified version of Klöppel's pathological classification.(ABSTRACT TRUNCATED AT 250 WORDS)

Ampulla of Vater↗
PubMed1983

Use of labetalol during anesthesia for pheochromocytoma removal.

Labetalol, an alpha and beta adrenergic blocking drug, was used during anesthesia for removal of a very large pheochromocytoma which was predominantly epinephrine secreting. The 70-year-old female patient suffered from angina pectoris and chronic bronchitis. A preoperative treatment including an alpha-adrenolytic drug was administered but beta-adrenergic blockers were avoided because of the risk of cardiac decompensation and bronchoconstriction. During the operation, hypertensive peaks were easily controlled by bolus injections of labetalol 20 mg. The removal of the tumor was followed by a transient moderate hypotension. Heart rate remained stable throughout the operation. No hemodynamic problems occurred during the postoperative period. With regard to this case, a summary of the literature concerning the properties of labetalol is presented.

Adrenal Gland Neoplasms↗