PubMed Health⌕ Search

Biomedical subjects

M Vankemmel

Publications and source records attributed to M Vankemmel.

At least 19 recordsLinked to original sources
PubMed1990

[Bilio-digestive bypass using gallbladder in chronic pancreatitis. 85 cases of cholecystoplasty ].

For a group of 368 cases of chronic pancreatitis (CP) operated on since 1975, the authors have performed 85 biliary intestinal anastomoses using the gallbladder, for treatment of biliary obstruction. (These were cases not needing resection of the head of the pancreas). This original biliary-intestinal by-pass comprises resection of the cystic duct then bridging the gallbladder between the common bile duct and the duodenum (in 2 cases the jejunum). This anastomosis of common bile duct to infundibulum was termino-terminal except in 15 where portal vein dilatation necessitated a latero-terminal anastomosis. The gallbladder-intestinal anastomoses were termino-lateral. One patient with multi-system disease died on the 20th post-op day from cardio-respiratory problems not directly related to the procedure. No fistulae, biliary or intestinal occurred. The average hospitalization was 13.6 days. The average follow-up period is now 46 months (2 patients only have been lost to follow-up). One patient (not abstaining from alcohol) has presented with recurrent febrile episodes and transient alkaline phosphatase elevations. Two patients only have been re-operated (9th and 72nd months) for cholangiocholitis necessitating a re-do of the anastomosis infundibulum to bile duct. These 2 patients are well at 20 and 45 months respectively. No biliary calculi have been observed, with 22% of patients now being more than 5 years post-op. The authors have progressively left aside the anastomosis to a jejunal loop in favour of the gallbladder interposition described. This appears a better procedure for treating biliary obstruction in chronic pancreatitis even when complicated by portal vein dilatation. This procedure enables drainage of bile into its natural site at the 2nd part of the duodenum, so reducing the risk of ulceration. It also saves extending the operating field below the mesocolon and importantly in the already poorly nourished patient, it does not remove from function a segment of jejunum.

Adult↗
PubMed1990

[A new method for pseudocysto-duodenostomy as therapy in pancreatic pseudocyst in chronic pancreatitis].

Reference in the surgical literature to the use of pseudocysto-duodenostomy whether laterolateral by Ombredanne [6] or transduodenal by Kerschner [4], is uncommon. The author with the aid of specially designed three-jaw prong, now, prefer to use pseudocysto-duodenostomy. From 1970, 411 patients underwent surgery for complicated chronic pancreatitis. 67 of the 93 patients requiring an internal cysto-intestinal procedure were treated by pseudocysto-duodenostomy; 11 additional patients were treated by derivation in the first retroperitoneal transposed jejunal loop. Postoperative mortality for the first month was 0%. The actuarial survival rate at 5 years was 86.9%. These satisfactory results have encouraged us to compare this new operative method with cystojejunostomy. It allows pancreatic secretions to drain into their natural anatomical site. Compared with external drainage it avoids the often prolonged and costly complications.

Anastomosis, Surgical↗
PubMed1990

Bacterial translocation in colorectal cancers.

Bacterial translocation, the passage of viable indigenous bacteria from the gastrointestinal tract to the mesenteric lymph nodes and other internal organs, has been poorly studied in man to date. Pericolonic lymph nodes, liver, portal blood, and peritoneum specimens were harvested before antibiotics were administered during 20 operations for colorectal cancer and compared with those obtained in 20 operations for non colorectal conditions. Bacterial translocation, defined as the presence of intestinal bacteria in at least one of the specimens, was found in 13 patients (65 percent) in the colorectal cancer group as compared to 6 (30 percent) in the control group (p less than 0.05). The increased incidence of bacterial translocation in colorectal cancers was mainly due to the presence of bacteria in the pericolonic lymph nodes adjacent to the cancer. These findings suggest that intestinal bacteria translocate from the bowel lumen in a high proportion of patients with colorectal cancer and further stress the need for prophylactic antibiotics in colorectal cancer surgery.

Adenocarcinoma↗
PubMed1987

[X-ray computed tomographic diagnosis of connective tissue tumors of the stomach of extrinsic development. Apropos of 6 cases].

Computed tomography findings appear to be very useful for the diagnosis of exogastric tumors on the basis of six cases: 4 leiomyosarcomas, 1 leiomyoblastoma and 1 schwannoma. The diagnosis of these usually large tumors arising within the gastric wall is often difficult through baryum opacification of the stomach (U.G.I.) owing to their exogastric growth. In the same way, endoscopy usually fails to evidence these tumors. Computed tomography permits to rule out an extrinsic tumor such as a hepatic or pancreatic one for instance and then to demonstrate the tumor originates within the gastric wall. The hypervascular pattern associated in most cases with central necrosis is demonstrated through contrast medium injection, what is a very typical and relatively constant-finding in these tumors.

Aged↗
PubMed1979

[Acute necrotizing pancreatitis and post-operative irrigation-lavage].

A series of 62 operated cases of acute necroto-hemorrhagic pancreatitis is presented along with discussion of the four principle objectives of surgical treatment: exposure, evaluation and selective resection of the lesions followed by close observation. Based on peroperative determination of anatomic site and macroscopic character, a double codification for each lesion is proposed. This codification provides the surgeon an objective basis for his choice of the type of procedure to be done. The surgery itself has a dual purpose: to eradicate frank necrosis and to protect the remaining tissue from autodigestion by installing one or more drains for irrigation and lavage of the lesion site. In the case of stage 3 necrosis, the procedure must include a left pancreatectomy of varying extent.

Anti-Bacterial Agents↗
PubMed1978

[Focalized irrigation-lavage and sequential use of a new antiseptic by local and general route. Preliminary report apropos of 2 cases of suppurative pancreatic necrosis].

In view of the severe course seen in the presence of any suppurated pancreatic necrosis, it was felt to be of value to treat two patients by the adjuvant use of a new antiseptic tauroline, administered locally and, where appropriate, systemically. After surgical excision of pancreatic and peripancreatic necrotic tissue, the authors prefer to avoid active suction drainage of the residual pocket, replacing it by continuous and prolonged post-operative irrigation-lavage, together with the sequential, twice-daily use of a solution of 2 p. 100 tauroline. In view of the presence of a Gram negative septicemia (organisms identical to those of the suppurated area), the same substance was given by intravenous infusion in a 0.5 p. 100 solution, this being the only systemic, anti-infectious therapy. The effectiveness, good tolerance and originality of this new substance, active against Gram negative, Gram positive, aerobic and anaerobic organisms as well as yeast, have led the authors to immediately report their initial experience with its use.

Administration, Topical↗
PubMed1976

[Spontaneous sub-capsular haematoma of the liver compressing the hepatic veins. Angiographic diagnosis (author's transl)].

Apart from special types encountered in neonates and during pregnancy, spontaneous sub-capsular haematoma (SCH) of the liver is a rare condition which is usually not recognized before operation. The diagnostic value of arteriography is emphasized by this case of SCH in a 29 year old man which presented spontaneously with the appearance of a large mass in the right hypochondrium with fever and pain. Angiographic changes identical to those seen with a traumatic SCH were found and, in this case, were accompanied by a local reversal in intra-hepatic portal flow related to a tumoural Budd-Chiari phenomenon (compression of the hepatic veins by the haematoma). Despite histological study of the liver, no tumoural, vascular, infective or parasitic aetiology could be found to explain this apparently idiopathic spontaneous SCH.

Adult↗