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Biomedical subjects

R Bourgeon

Publications and source records attributed to R Bourgeon.

At least 19 recordsLinked to original sources
PubMed1987

[Sclerosing cholangitis and biliary sequelae of hydatid cyst of the surgically treated liver].

Worldwide literature and ten or so personal cases are reviewed as a basis for distinction or intrication of two aspect of post-hydatid sclerosing cholangitis; that of a localized lesion of diffuse lesions of the biliary tract. In both cases the action of the hydatid cyst is not due to toxins but to pressure on biliary duct walls, very variable according to site and size. This local action may be the only cause, provoking a specific type of lesion, a true sequela of an incomplete or delayed operation. In certain regions, or in the presence of biliary stasis and angiocholitis, passage of hydatid fluid into biliary tracts, normally tolerated by healthy biliary pathways, leads to a diffuse sclerosing cholangitis. The serious consequence of this eventuality is proved by the failure of many treatments, with subsequent inevitable liver transplants. Clinical circumstances and data explaining this complication allow necessary precautions to be taken. Furthermore, early treatment of hydatidosis or as radical as possible therapy for advanced lesions is curative of localized forms of the disease.

Bile Ducts↗
PubMed1986

A curative surgical approach to gallbladder carcinoma in its early stages.

The study is based on 20 personal cases of gallbladder cancer and 254 similar cases from five surgical departments. The contradictory results obtained by surgery are explained by the special structure of the gallbladder wall and the bipolar connections with the liver and lymphatic ducts. Personal experience and literature reports evidence the possibility of cure for various stages: macroscopic lesions, while qualified as early stages are actually already advanced and necessitate extended liver resection with considerable lymph node dissections; the so-called early stage, detectable solely by histology, is harmful since the entire thickness of the mucosa is involved and always requires enlarged cholecystectomy to include the liver and lymph nodes. In this case good survival rates are possible; in situ pre-epithelial lesions diagnosed by cytology, are amenable to cure by simple cholecystectomy. Prevention rests on a wide range of indications for cholecystectomy (lithiasis, female sex, age over 50 years).

Adult↗
PubMed1984

[Hepatic resection as necessary in liver injuries].

The fact that experience has been gained during four successive episodes since 1940 emphasizes the progress accomplished in the fields of therapeutic indications and surgical techniques for these lesions. Resection "on request" is effective both as therapy of hemorrhage and escape of bile: conducted under the control of regional hemostasis it is the most sparing of healthy parenchyma while being effective and complete. It can be adapted for emergency cases, or used as first intention surgery as well as in delayed cases or previously operated patients. Results are particularly interesting in the absence of associated lesions.

Cholestasis↗
PubMed1979

[Hepatic metastases of colonic and rectal carcinoma: surgical treatment (author's transl)].

Statistical results show a marked improvement in survival after surgical treatment of hepatic metastases. The possibilities of surgery are evaluated after precise analysis of the lesions seen at the time of excision and not at autopsy. The data from assessment which indicate that surgery will be successful are described and discussed. Surgical techniques consist above all of resection: metastasectomy, segmentectomy, hemihepatectomy and hepatectomy followed by transplant. Other methods are palliative. Certain resections themselves appear to be palliative and the ideal is to carry out adequate resection at the outset, adapted to the size and site of the lesions. However the possibilities of surgery form part of an overall programme: -- complete removal of the primary carcinoma in order to avoid any local recurrence, -- wide eradication of metastatic lesions, -- préventive treatment against further development of possible subclinical lesions by post-surgical chemotherapy and subsequent immunotherapy.

Colonic Neoplasms↗