[Diffuse peritoneal carcinosis of pseudo-papillary and solid tumor of the pancreas. Role of abdominal injury].

We report the case of a young girl with diffuse peritoneal carcinomatosis due to pseudopapillary and solid tumor of the pancreas. Fourteen months before the diagnosis and treatment of the tumor, an abdominal trauma occurred. Initial treatment was tumor and visible peritoneal carcinomatosis resection.

Prospective study of microscopic lymph node involvement of the hepatic pedicle during curative hepatectomy for colorectal metastases.

Extensive lymph node dissection of the hepatic pedicle was undertaken in 100 consecutive patients undergoing curative hepatectomy for colorectal liver metastases in whom lymph node involvement of the hepatic pedicle was not macroscopically detectable. Microscopic lymph node involvement was found in 14 patients, in very different lymph node sites, and was related only to the number of metastases, extent of liver involvement and carcinoembryonic antigen level (all P < 0.05).

Surgery for lung metastases from colorectal cancer: analysis of prognostic factors.

Purpose: To identify prognostic factors of improved survival after resection of isolated pulmonary metastases (PM) from colorectal cancer.

Patients And Methods: A retrospective analysis of the records of all patients with PM from colorectal cancer who underwent thoracic surgery with curative intent before December 1992 at a single surgical center was performed. Univariate (log-rank) and multivariate (Cox's model) analyses of survival were used to identify significant prognostic factors.

Lymphangioma of the diaphragm (first case report).

Intraabdominal cystic lymphangioma occurs rarely, and lymphangioma of the diaphragm has not been previously reported in the literature. The authors herein report the clinical features, radiographic findings, and treatment of one encountered case of lymphangioma of the diaphragm.

[Adenocarcinoma of the cardia: does the extent of gastric resection and lymph node excision influence survival?].

Objectives: In the curative treatment of the adenocarcinoma of the cardia (AC), the extent of the esogastrectomy and the need for lymph node dissection are still debated. The palliative treatment of AC is now currently non-surgical. The aim of this study was: a) to assess early results of palliative surgery; b) to evaluate the results of curative resection with reference to the influence of the extent of gastrectomy and lymph node dissection on early results and long-term survival.

Diagnosis of choledocholithiasis by endoscopic ultrasonography.

Background/aims: Endoscopic ultrasonography is a promising procedure for the diagnosis of extrahepatic cholestasis. Accuracy for the diagnosis of choledocholithiasis by ultrasonography and computed tomography were prospectively compared with endoscopic ultrasonography in 62 consecutive patients.

Methods: Final diagnosis was determined by endoscopic retrograde cholangiography with or without sphincterotomy or intraoperative cholangiography with or without choledochoscopy.

Endoscopic ultrasonography in the diagnosis and staging of pancreatic adenocarcinoma. Results of a prospective study with comparison to ultrasonography and CT scan.

Endoscopic ultrasonography (EUS) was compared to ultrasonography (US) and CT scan (CT) in order to evaluate its role in the diagnosis and the locoregional spread assessment of pancreatic cancer. Sixty-four patients suspected of pancreatic cancer were studied prospectively, and the results of imaging techniques were compared to histology and surgical exploration. There were 49 cases of pancreatic adenocarcinoma, 11 of pancreatitis, 2 of common bile duct carcinoma, 1 lymphoma and 1 hepatocellular carcinoma with peripancreatic metastatic lymph nodes.

Persistence of systemic and splanchnic hyperkinetic circulation in liver transplant patients.

Portal pressure and portal-systemic collateral circulation after orthotopic liver transplantation have not been investigated. We studied systemic and splanchnic hemodynamics in 17 patients with cirrhosis before and 205 +/- 146 days after orthotopic liver transplantation. Among the 17 orthotopic liver transplantation patients, 12 had undergone hemodynamic study in the 6 mo before orthotopic liver transplantation.

[Ultrasonic endoscopy of superficial epidermoid cancer of the esophagus].

Superficial squamous cell carcinomas of the oesophagus are defined as cancers confined to the mucosa or involving the submucosa but sparing the muscularis mucosae, with or without lymph node extension. Although lymph node involvement is rare (less than 5%) in tumours confined to the mucosa, it is frequent (30 to 45%) in tumours involving the submucosa, which have a prognosis similar to that of the usual obstructive tumours. Endoscopic ultrasonography is the most accurate examination (diagnostic accuracy greater than 95%) to distinguish between superficial and advanced cancers.

[Associated cancers of the esophagus and the lung].

The combination of cancers of the esophagus and of the ENT region has been extensively studied. Strangely enough, only a few cases of associated cancers of the esophagus and of the lung are reported in the literature. The authors report about 38 cases, including 21 with synchronous tumors and 17 with metachronous tumors.

[Salvage esophagoplasty using free jejunal transplant after repeated failure of other esophagoplasties. 25 cases].

Salvage oesophagoplasty using a free jejunal transplant is the ultimate reconstruction possible after repeated failures using the classic procedures of oesophagoplasty. The free jejunal transplant appears to be the best choice. Twenty-five free jejunal transplants were performed by the same surgeon for such reconstructions including 13 cases involving benign lesions and 12 cases of cancer.

[Liver transplantation without clamping the vena cava inferior].

An original technique of orthotopic liver transplantation with preservation of the recipient's entire inferior vena cava and side-to-side caval anastomosis is described. The procedure was used in 21 consecutive patients. It has permitted to avoid vena cava occlusion and the need for venous bypass.

A new technique of side to side caval anastomosis during orthotopic hepatic transplantation without inferior vena caval occlusion.

An original technique of OLT with preservation of the entire IVC of the recipient and side to side caval anastomosis is described. The procedure has permitted the avoidance of retrocaval dissection and temporary vena caval occlusion. The caval outflow was respected during the anhepatic phase.

[Liver transplantation without clamping of the inferior vena cava].

An original technique of orthotopic liver transplantation with preservation of the recipient's entire inferior vena cava and side-to-side caval anastomosis is described. This procedure was used in 21 consecutive patients. It has permitted to avoid vena caval occlusion and the need for venous bypass.

[Cancer on an esophageal diverticulum].

Carcinoma is one of the most severe complications of oesophageal diverticula. Its incidence varies from almost zero to 4 percent. The authors report 4 cases of carcinoma arising in a pharyngo-oesophageal diverticulum and 2 cases involving a diverticulum of the oesophageal body.

[Contribution of fibrin glue to the reinforcement of esophageal anastomoses].

A prospective randomized study was conducted on 100 patients operated upon for oesophageal diseases to evaluate the usefulness of fibrin glue in reinforcing oesophageal anastomoses. The anastomoses were located in the neck, the chest or the lower mediastinum. The operative mortality rate, the number and severity of fistulae and the incidence of anastomotic stenosis were studied.

Concurrent superficial squamous cell carcinoma of the esophagus and early gastric adenocarcinoma. Report of a case.

We report a patient with concurrent superficial carcinomas of the esophagus and stomach. The tumors occurred in a 68-year-old woman. The esophageal tumor was an intramucosal squamous cell carcinoma, and the gastric tumor an intramucosal adenocarcinoma, type III in the Japanese classification of early gastric cancer.

[Reoperations for failure of gastroesophageal reflux surgery. Apropos of fifty reoperations].

Fifty patients were reoperated for failed antireflux procedures or post-fundoplication symptoms. Cases of severe esophagitis, that is stenosis or Barrett's esophagus, were excluded. The usual cause of failure was a technical error.

[Role of resection of the celiac plexus in the analgesic treatment of pancreatic cancers].

The aim of this study was to evaluate the pain relief related to resection of the celiac plexus in pancreatic carcinoma. This technique was attempted in 26 consecutive patients and performed in 23 (feasibility: 88%), whose mean age was 64 years. Before surgery, patients were divided into two groups: patients not treated by narcotic analgesics (group 1, n = 10) and patients treated by narcotic analgesics (group II, n = 13).

Pancreaticogastrostomy after pancreatoduodenectomy.

The aim of this study was to evaluate the place of pancreaticogastrostomy (PG) in reducing pancreatic fistula after pancreatoduodenectomy. From January 1988 to June 1991, 32 consecutive patients (mean age, 57 years) were operated on, 25 for malignant disease (78%). The pancreatic remnant was normal in 17 patients (53%) and sclerotic in the others.