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Biomedical subjects

Y Salembier

Publications and source records attributed to Y Salembier.

At least 19 recordsLinked to original sources
PubMed1977

[Short choledochus. Attempted systematization].

It is necessary to clearly characterize: -- The short choledochus which, in fact, is a long cystic duct joining the ampulla of Vater (4 obs.). -- The choledochus with a high implantation, above the end part of the duodenum (4 obs.). -- The choledochus shortened by the retraction of the duodenum, more often than not induced by a distant duodenal ulcer (1 obs.). The long cystic must be removed if possible. The high implanted choledochus, when associated with a duodenal ulcer leads to etiological (-- mutual action of the two diseases --) and practical problems: it seems preferable, in this case, to leave the ulcer and cure it by an indirect operation.

Adult↗
PubMed1977

[Surgical problems of the primary sclerosing cholangitis (author's transl)].

The characteristics of the primary sclerosing cholangitis are a diffuse inflammation with fibrous thickening and narrowing of the biliar ducts. Two observations replying to strict characteristics are related. From attacks of angiocholitis, the disease generally progresses till a parmanent icterus and death occurs in a state of biliar cirrhosis. In the liver, the micro pathology consists in fibrous rings constricting the segmentary interlobular ducts. The diagnostic is mainly difficult and the prognostic is fatal in average time of 4 years of evolution althought we used corticoids that were administrated by local method as well as in the classical general way.

Adult↗
PubMed1975

Removal of intrahepatic bile duct stones.

To keep this study homogeneous, we have limited ourselves to intrahepatic lithiases of the bile ducts above the hilus, usually linked with extrahepatic lithiases. While operating, all technical resources must be utilized in order to remove as many stones as possible. To gain access to the hepatic duct, it is sometimes necessary to excise the hilar plane; scissurotomy is the most efficient way to free the intrahepatic ducts when they are full of stones. In rare cases of localized lithiases, one may perform hepatic resection. We have perfected a technic using a special malleable catheter, guided by television, combined with suction of the stones for intrahepatic blocked stones. Forty-four interventions are presented. We have grouped them according to whether they involved an accumulation of stones from the extrahepatic ducts or stones blocked in a bile duct. There were three cases of dispersed intrahepatic lithiasis and one peripheral localization. Following extraction of the stones, we ended the intervention by 19 Kehr drainages, seven choledochotomies, five sphincterotomies, 11 biliodigestive anastomoses, one hepatectomy and one hepatotomy. We deliberately left some stones undisturbed in seven cases: the results even after some years remain satisfactory except for one case of dispersed lithiasis.

Adult↗
PubMed1975

[Original techniques for biliary surgery (author's transl)].

1. Aspiration of intrahepatic stones. This uses a catheter designed for selective aortography with a special probe, short and provided with a soft cap. The instrument is inserted in the hepatic canal to the contact of the stone, under TV guidance. Strong suction allows extraction. 2. Hepato-gastric prosthesis as palliative. Treatment for cancer of the biliary tract. A. Pezzer sound is placed in a dilated hepatic canal at one end, the other being fixed in the stomach. This is an ultimate solution for far advanced cases, that can only suppress the itching.

Bile Duct Neoplasms↗
PubMedDate not supplied

Surgical problems in primary sclerosing cholangitis.

The characteristics of primary sclerosing cholangitis are a diffuse inflammation with fibrous thickening and narrowing of the biliary ducts. All patients who have stones or have been operated on for biliary disease (risk of traumatic stenosis) must be excluded in discussions of this disease. Two observations illustrating the strict definition of its characteristics are related. From attacks of angiocholitis, the disease generally progresses to a permanent jaundice. Death occurs in a state of biliary cirrhosis. Liver histopathologic changes consist of fibrous rings constricting the segmentary interlobular ducts. Physiopathologic changes of the disease are difficult to define precisely except in cases with coexistent ulcerative colitis (1/3 of cases). The diagnosis is difficult. Illustrative examples are presented: A syndrome of stenosis in a patient in whom no stones were found during the operation but the lesions were typical of the passage of stones. The prognosis was good. One patient seemed rather typical but the rapid evolution and finally a finding of carcinomatous tissue led to the diagnosis of cancer of the biliary duct. One patient had cirrhosis with extrahepatic stenosis. Histologic studies, cholangiolitis and obstructive pericholangiolitis indicated the correct diagnosis. The disease is usually fatal within four years of onset despite administration of corticoids locally and systemically.

Adult↗