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Biomedical subjects

R Parc

Publications and source records attributed to R Parc.

At least 145 records · Page 8Linked to original sources

[Results of choledoco-duodenostomy for common bile duct lithiasis].

One hundred and sixty-seven choledoco-duodenostomies for lithiasis of the common bile duct (CBD) were performed. The mean age of the patients was 74 +/- 1 years. Sixty p. 100 of the patients presented with at least one operative risk factor, usually related to their general condition. An anastomosis of at least 20 mm in diameter was possible as the diameter of the CBC was always larger than 10 mm. Immediate postoperative complications (within one month) were observed in 29 cases (17 p. 100). In 14 cases (8 p. 100), these complications were directly related to the operative procedure and, in 15 cases (9 p. 100), bronchopulmonary or cardiovascular complications occurred. Operative mortality was 4 p. 100 (7 cases); in 2 cases, death was directly related to the operative procedure, and in 5 cases, death was not directly due to surgery. Operative complications were significantly higher in the case of emergency procedures, impaction of the CBD by multiple stones, and associated acute cholecystitis. One hundred and thirty-four of the 160 survivors (84 p. 100) have been followed for a mean duration of 5 years (63 +/- 7 months); 115 (86 p. 100) have remained asymptomatic. Eleven patients had non specific findings; 8 (6 p. 100) had cholangitis, half of them having suffered from only one episode. The first (or only) episode occurred during the first postoperative year in 7 out of 8 patients. No cholangitis developed after the second postoperative year in patients still asymptomatic. No anastomotic stenosis was found in any of these cases. One case of stump syndrome was observed. These results suggest that choledocoduodenostomy is a reliable procedure for treatment of choledocolithiasis and related late complications are rare.

Aged↗

[Surgical resection of hepatocellular carcinoma. Retrospective study of 42 cases].

We studied the results 42 liver resections performed for hepatocellular carcinoma. Thirty-three patients underwent major liver resections. Hepatocellular carcinomas were associated with cirrhosis in 30.9 p. 100 of cases. The overall operative mortality was 24.3 p. 100: 60 p. 100 in patients with cirrhosis who underwent major liver resections and 12.5 p. 100 in patients with cirrhosis undergoing limited resections. The overall 5-year survival rate was 14.8 p. 100; the 5-year survival rate in patients with hepatocellular carcinoma without cirrhosis was 20 p. 100 whereas no patient with associated cirrhosis of the liver survived at 3 years. We conclude that surgical resection of hepatocellular carcinoma must be performed whenever possible: a limited resection should be done if the tumor is small, especially in patients with cirrhosis; a major liver resection must be proposed when the tumor is large and if the remaining liver parenchyma is normal.

Carcinoma, Hepatocellular↗

[Leiomyosarcoma of the small intestine. Apropos of 3 cases].

The authors report three cases of leiomyosarcomas of the small intestine and review the literature on this subject. Leiomyosarcomas of the small intestine are rare tumours, representing 0.2% of all malignant tumours of the gastrointestinal tract. These large, round, hypervascular tumours are derived from smooth muscle cells in the intestinal wall and often develop extra-luminally. The malignant nature is often difficult to confirm on the histological examination. The clinical signs often only appear when the tumour has reached a large volume. It is rare to make the diagnosis pre-operatively, despite the use of a number of investigations. Arteriography is the most reliable examination. Spread of the disease is essentially haematogenous. The malignant tumour invades adjacent organs, causes hepatic metastases and peritoneal seedlings and tends to recur locally. The treatment is essentially surgical and the prognosis varies according to the size of the tumour, its grade, its activity and its degree of extension. The 5-year survival of all forms of the disease varies between 20 and 50%, according to the series.

Aged↗