[Total colectomy and ileorectal anastomosis in Crohn's colitis. Functional results and recurrence factors (83 cases)].

Eighty-three consecutive patients (38 men, 45 women) underwent colectomy and ileorectal anastomosis (IRA) for Crohn's colitis between 1960 and 1988. The mean age at the time of IRA was 28.5 years after a mean interval of four years from diagnosis.

[Ileo-anal anastomosis in familial adenomatous polyposis: procedure of choice?].

Surgical treatment of familial adenomatous polyposis (FAP) remains controversial. The arguments in favour of ileal pouch-anal anastomosis (IPAA) are well known. All the premalignant mucosa is removed and the risk of rectal carcinoma is avoided.

[Treatment of portal hypertension].

Injection sclerotherapy is the mainstay of treatment for acute variceal bleeding and for long-term management after a variceal bleed in 1993. However, the new technique of oesophageal variceal ligation may prove to be superior, either alone or in combination with low dose sclerotherapy. Pharmacological therapy for acute variceal bleeding is widely used and somatostatin appears to be the most effective agent.

["Piggyback" method in hepatic transplantation].

Using the traditional technique for liver transplantation, there are two supra and subhepatic anastomoses to the vena cava. With the piggy-back method, the donor's inferior vena cava is implanted terminolaterally into the recipient's inferior vena cava. The aim of this work was to evaluate results in two matched groups.

[Colonic complications of acute necrotizing pancreatitis].

Among 126 patients operated upon for acute necrotizing pancreatitis in our department over a 10-year period starting in November 1979, 17 had a colonic resection. Colectomy was made mandatory by a necrotic or ischaemic appearance (12 cases, including 3 bowel perforations), an isolated perforation (2 cases) or extensive fat necrosis of the pericolonic atmosphere (3 cases). The hospital mortality was 5 out of the 17 cases.

Tumours of Oddi: diagnosis and surgical treatment.

A retrospective review of 56 patients operated upon for tumours of Oddi was performed in order to determine optimal diagnostic and therapeutic procedures. Common presenting symptoms were jaundice (86%) and anemia (21%). Mean size of the tumour was 2.

Bleeding pseudocysts and pseudoaneurysms in chronic pancreatitis.

Spontaneous haemorrhage associated with chronic pancreatitis in 17 patients was related to a pseudocyst in 15 (88 per cent) patients and to pancreatic lithiasis (one patient) or to infarction-rupture of the spleen (one patient). Bleeding was massive in six patients and intermittent in 11. It resulted from erosion of the gastroduodenal or the splenic artery in four patients.

[Experimental models for hepatic metastases from colorectal tumors].

Over recent years, the interest in the development of experimental models of colorectal liver metastases has increased due to the need for new adjuvant therapies to improve the treatment of both colorectal cancer and liver metastases. The induction of colon cancer by carcinogens in the rat with spontaneous liver metastases fairly closely mimicks the natural history of colon cancer but a low yield of both colonic cancer (less than 50%) and liver metastases (approx. 25%) is obtained after 6 months of latency.

[Ileo-anal pouch anastomosis: results in ulcero-hemorrhagic rectocolitis and in familial adenomatous polyposis].

Two hundred twenty-four ileal pouch-anal anastomoses have been made, 122 for ulcerative colitis and 102 for familial adenomatous polyposis. All the patients had a J pouch and a diverting temporary ileostomy. Mortality was 0.

The isolated perfused rat spleen. An original method for studying the function of hepatocytes transplanted into the spleen.

The aim of this study was to assess directly the function of isolated hepatocytes 1 year after transplantation into the spleen, using an original model of isolated rat-spleen perfusion. Three specific liver functions, albumin synthesis, indocyanine-green clearance, and antipyrine oxidation, were studied. Five x 10(6) isolated hepatocytes were injected into the spleen of syngenic Wistar-Furth rats.

[Reoperation in severe hepatic trauma. 30 cases].

From 1978 to 1987, thirty patients were secondarily referred to Saint-Antoine Hospital for the treatment of their hepatic trauma. Seventeen were referred because of a postoperative complication (group I) and thirteen after peri-hepatic packing (group II). In group I, transfer was decided because of hemorrhage (8 patients), sepsis (6 patients) and haemobilia (3 patients).

High-output external fistulae of the small bowel: management with continuous enteral nutrition.

Three hundred and thirty-five patients with high-output enterocutaneous fistulae arising from the small intestine are reported. Median fistula output was 1350 ml/24 h. Eighty-two per cent of patients were referred from other institutions.

Continuous enteral nutrition during the early adaptive stage of the short bowel syndrome.

Sixty-two patients with the short bowel syndrome (30-150 cm) were managed by continuous enteral nutrition (CEN) in the early adaptive phase. In all, 82 per cent were referrals from other units and 85 per cent of referrals had failure of one or more organ systems on admission. There were intra-abdominal abscesses in 41 per cent of patients and 37 per cent had an enterocutaneous fistula.

[Surgical treatment of Oddi's sphincter tumors. Apropos of 56 cases].

The records of 56 patients operated upon for ampullary tumors were reviewed in order to determine the best way to diagnose and treat these tumors. Thirty six males and 20 females, 30 to 89 years old, were operated upon between October 1970 and October 1985. Eighty six p.

[Colo-anal anastomosis with reservoir in the treatment of rectal cancer].

Preservation of the anal sphincter system is now often considered in the treatment of adenocarcinomas of the mid-rectum (inferior limit between 11 and 6 cm of the anal margin). Direct anastomosis of the rectum to the anus or the last two centimeters of the rectum after resection of the rectal pouch is a source of discomfort. The construction of a colon pouch, placed directly above the anus, has been devised in order to improve these results.