[Surgical treatment of the Zollinger-Ellison syndrome. Apropos of 7 cases].
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Biomedical subjects
Publications and source records attributed to M Mercadier.
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A series of 52 hydatid cysts of the liver is reported. It is emphasized that diagnosis should be easily done with simple explorations as liver scan, echography, immunologic tests. As far as treatment is concerned the possibility of anaphylactic accidents during operation must be kept in mind. To avoid as much as possible postoperative complications special attention must be taken in the choice of the operative technic. In young, unilocular cysts hydatidectomy should be performed. In old cysts complete resection of both cyst and adjacent hepatic parenchyma (pericystectomy) gives the best results.
Patients undergoing cholecystectomy were randomly divided into two groups. The effects of a single injection of one gram of cefazoline given thirty minutes before operation to 30 patients were compared with those obtained in a second group of 29 untreated cases. The efficiency of the second generation cephalosporins in preventing postoperative complications of this type was confirmed. Prophylactic administration of this antibiotic therapy before uncomplicated biliary tract surgery can significantly reduce the incidence of postoperative parietal infections and therefore the duration of hospitalization.
The authors report 3 cases of gastrectomy with terminal duodenostomy in patients which were operated on in emergency for large duodenal ulcers. They outline the history of this method, which seems to be seldom used in France. Technic and results are presented. This procedure is advised when closure of the duodenal stump is difficult and may lead to postoperative leakage : it is therefore advocated in large perforated ulcers involving the anterior wall of the duodenum.
50 patients with a carcinoma of the head of the pancreas have been treated wether by duodenopancreatectomy (38 cases) or by total pancreatectomy (12 cases). Post operative mortality was 23.6% and 25%, mean survival 18 months and 9 months. Analyzing these results reviewing the literature the authors conclude that in limited tumors resection is preferable to palliative surgery. The choice between duodeno pancreatectomy and total pancreatectomy remains difficult and it will only be analysis of more extensive series which might give the answer.
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