Biomedical subjects
Publications and source records attributed to T de Cervens.
It is essential to detect section planes during hepatectomy, notably for limited resections in cirrhotic patients. The authors describe a technical artifice, the use silicon-impregnated compresses, to help in the peroperative ultrasonographic detection of these section planes.
Liver-cell carcinomas generally occur in cirrhotic livers; their surgery is difficult when they are located in the caudate lobe. After an anatomical summary, the authors propose a topographic classification of these tumors and describe the surgical strategy to be implemented.
From 1960 to 1987, 22 neonates were treated at the Institut Gustave-Roussy for a Pepper' syndrome. During this period of time, 83 children were treated for the same syndrome, the neonatal type representing 26% of cases. Twelve of the 22 neonates presented with the rapidly evolving type, requiring an immediate aggressive treatment. In 4 of them death occurred early despite treatment. The 10 other neonates presented with a slowly progressive disease. In 5 of them treatment of the metastatic disease was not necessary to obtain remission. The survival rate of disease without relapses in 77%, with a median follow-up of 8 years. So, despite the high incidence of rapidly progressive forms, the prognosis of this disease remains favorable in neonates, provided an accurate treatment initiated early.
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The authors present their experience from February 1988 with biliary lithotripsy in 125 patients. They review the protocol inclusion criteria and the various forms of complementary medical treatment. From this group, 30% of the patients underwent cholecystectomy, 45% received medical treatment and only 25% did not eventually require complementary medical therapy.
Hepatectomy for liver cell carcinoma in cirrhosis patients requires peroperative echographic control. Basel on their experience at the National Cancer Center Hospital in Tokyo (more than 500 hepatectomies of cirrhosis livers), the authors describe the advantages of peroperative echography and surgical techniques of various segmentectomy procedures.