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T Billebaud

Publications and source records attributed to T Billebaud.

51 records · Page 3Linked to original sources
PubMed1986

[Pyelo-duodenal fistula complicating pyelonephritis].

The authors report a case of a pyeloduodenal fistula secondary to a gravidic pyelonephritis. The diagnosis was based on intravenous urography. The etiology was probably an unnoticed dysectasia of the pyelo-ureteral junction. The patient recovered following nephrectomy and duodenal suture. The authors conclude with a discussion of the diagnostic and prognostic interest of percutaneous nephrostomy in the management of this rare complaint.

Adult↗
PubMed1985

[Contribution of intraoperative echography in hepatic metastases].

Current research is devoted to the most appropriate treatment for hepatic metastases. Intra-operative ultrasonography is very valuable for assessing metastatic lesions, their exact number and their topography in relation to surgical landmarks such as the fissures and the hepatic pedicles. Surgery can then be adapted (metastasectomy, segmentectomy, hepatectomy) in relation to the peripheral parenchyma and the remaining parenchyma. The authors present the results of intra-operative ultrasonography performed at the hôpital Broussais in the diagnosis and treatment of 41 hepatic masses. In every case, the treatment of choice was surgical resection and chemotherapy was only administered as second line therapy in cases of failure.

Humans↗
PubMed1984

[Mucosecreting tumors of the appendix. 3 cases].

The three cases reported here illustrate the diagnostic, therapeutic and prognostic problems raised by these tumours. These are rare lesions with little suggestive symptoms, which explains why they are exceptionally diagnosed before surgery. Mucosal hyperplasias and cystadenomas are benign formations with a 90-100% survival rate 5 years after appendicectomy, even when non-cellular mucoid effusion is present. Cystadenocarcinomas are malignant tumours with mucoid secretion containing epithelial cells; they have a tendency to recur despite repeated evacuations, and their 5-year survival rate is approximately 25%; death results from intestinal obstruction or compression of intra-abdominal viscera by the mucoid substance.

Aged↗
PubMed1984

[Conservative surgical treatment of acute pancreatitis. Strategy and technic].

Not all patients with acute pancreatitis can be cured by medical treatment alone; surgery is mandatory when signs of aggravation or complications are present. The authors propose a new strategy involving bilateral subcostal laparotomy, wide approach to the pancreas, evaluation of the lesions and therapeutic decision: either abstention or excision which may be performed according to rules or adapted to each case. The abdominal wall is then closed, often around a pre- and peripancreatic Mikulicz's drain. This method has substantial advantages: the dangers of hasty and inappropriate surgical procedures on ill-defined lesions are avoided, necrotic areas can be removed, drainage is facilitated and possible reoperations are restricted to the supramesocolic cavity.

Acute Disease↗
PubMed1984

[Treatment of inguinal hernia with unsplit mersylene prosthesis. Significance of the parietalization of the spermatic cord and the ligation of epigastric vessels].

The authors describe their technique of "thorough" dissection of the spermatic cord by the inguinal route. After parietalization of the cord and ligature of the epigastric vessels, a wide prosthesis of unsplit mersylene can be inserted through the groin behind the muscular layer brought down to Cooper's ligament. From their experience of 120 patients operated upon and without relapse at follow-up, they feel able to recommend this method in cases of recurrent hernias with weak walls and large sac and of hernias occurring in elderly of obese subjects.

Hernia, Inguinal↗
PubMed1984

[Pancreatic cystadenocarcinomas. Apropos of a case and review of the literature].

A patient with a pancreatic cystadenocarcinoma was treated initially for a false pancreatic cyst by means of a Y loop, and then by total pancreatectomy three weeks later. Although the prognosis for these tumors amongst the group of pancreatic carcinomas is usually greatly improved, the patient died 6 months after detection of the lesion. However, a literature review also suggested possible prolonged survival in these cases when the tumors are discovered early enough and local or regional spread is absent: wide excision of the tumor without the need for total pancreatectomy may then be sufficient. The "false cyst" appearance frequently taken by this slowly progressing malignant affection has to be emphasized, as well as the need for the renewed classification of these tumors: serous cystadenomas are always benign and must be separated from mucinous cystadenomas that are malignant or are potentially malignant. A CT scan appears to be the investigational procedure providing the most accurate data for determining the limits of surgical excision.

Cystadenocarcinoma↗
PubMed1983

[Should preventive antibiotics be prescribed in surgery of the appendix, biliary tract, stomach and duodenum?].

Most infections occurring after biliary or gastrointestinal surgery are caused by dissemination of organisms present in the lumen of the biliary or the gastrointestinal tract at the time of operation. Randomized prospective studies have been performed with antibiotics active against organisms usually found in wound infections. Results have shown that cephalosporin, lincosamide and imidazole in appendicectomy, aminoside, cephalosporin, lincosamide and sulfamide in biliary surgery, and cephalosporin in gastro-duodenal surgery decreased wound infections. These results and prediction of wound sepsis following operations suggest a discriminate use of antibiotic prophylaxis in appendicectomy, gastro-duodenal and biliary tract surgery.

Anti-Bacterial Agents↗
PubMedDate not supplied

[Peroperative ultrasound scanning of the pancreas].

Intraoperative realtime high resolution ultrasound scanning of the pancreas seems to be a new and promising procedure. We have performed it in 28 patients: the normal ultrasound picture of pancreatic ducts and parenchyma was defined in 9 patients without pancreatic disease; in 19 patients with pancreatic disease, intraoperative ultrasound was compared with preoperative ultrasound examination. Seven of 8 patients with pancreatic carcinoma and 4 of 6 with calcifying chronic pancreatitis had positive findings, respectively. In 3 cancer patients, intraoperative ultrasound investigation avoided a long and unavailing dissection of the tumor by revealing extensive spread. In selected cases, intraoperative sonography allowed to characterize and to localize pancreatic carcinoma: portal vein invasion, relationship of the tumor to the duct of Wirsung and small hepatic metastases. In chronic pancreatitis, intraoperative ultrasound information concerning the dimensions of the pancreatic duct, the structure and the localization of pseudocysts was comparable to that obtained by radiological opacification. Furthermore, intraoperative ultrasound exploration guided proper incision and evacuation of pancreatic pseudocysts in two patients. Operative ultrasound seems to us to be mandatory during pancreatic surgery. Further experience with this technique is needed in a larger number of patients. However, we believe that it could replace intraoperative cholangiography and pancreaticography in the assessment of extension and complications of pancreatic disease.

Acute Disease↗
PubMedDate not supplied

[The role of endoscopy in the diagnosis and treatment of keratinizing and desquamating malpighian metaplasia of the kidney pelvis].

Keratinized squamous cell metaplasia of the renal pelvis (KSMRP) is a rare lesion, difficult to differentiate from urothelial tumour on the basis of the usual morphological examinations. It is therefore usually diagnosed retrospectively, on histological examination of a nephroureterectomy specimen. However, as its benign nature justifies conservative treatment, preoperative recognition of this lesion is essential. Upper urinary tract endoscopy, which allows diagnosis and treatment of this disease, is therefore very important in this context. Endoscopy is indicated when KSMRP is suspected clinically in a doubtful case of urothelial tumour of the upper urinary tract, in a context of passage of soft stones or a history of renal stones or upper urinary tract infection. Ureteroscopy constitutes the first step to confirm the diagnosis. It must be completed by a percutaneous procedure to eradicate any residual lesion, which could be responsible for recurrence. We report a case of KSMRP in a solitary kidney treated by retrograde and percutaneous endoscopic surgery.

Diagnosis, Differential↗