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Frey procedure for the treatment of chronic pancreatitis associated with common bile duct stricture

Hepatobiliary & Pancreatic Diseases International 2013年第6期12卷 637-644页

作者： lionel rebibo Thierry Yzet Cyril Cosse Richard Delcenserie Eric Bartoli Jean-Marc Regimbeau Department of Digestive Surgery Amiens University Medical Center the Jules Verne University of Picardie Department of Radiology Amiens University Medical Center and the Jules Verne University of Picardie Department of Digestive SurgeryAmiens University Medical Center and the Jules Verne University of Picardie Department of Gastroenterology Amiens University Medical Center and the Jules Verne University of Picardie

BACKGROUND:The Frey procedure(FP)is the treatment of choice for symptomatic chronic pancreatitis(CP).In cases of biliary stricture,biliary derivation can be performed by choledochoduodenostomy,Roux-en-Y choledochojejunostomy or,more recently,reinsertion of the common bile duct(CBD)into the resection *** objective of the present study was to evaluate the outcomes associated with each of these three types of biliary ***:We retrospectively analyzed demographic,CPrelated,surgical and follow-up data for patients having undergone FP for CP with biliary derivation between 2004and 2012 in our university medical *** primary efficacy endpoint was the rate of CBD stricture *** secondary endpoints were surgical parameters,postoperative complications,postoperative follow-up and the presence of risk factors for secondary CBD ***:Eighty patients underwent surgery for CP during the study *** these,15 patients received biliary derivation with the *** of the FPs(53.3%)were combined with choledochoduodenostomy,4(26.7%)with choledochojejunostomy and 3(20.0%)with reinsertion of the CBD into the resection *** mean operating time was *** complications(73.3%)were recorded,including one major complication(6.7%)that necessitated radiologicallyguided drainage of an abdominal *** mean(range)length of stay was 17 days(8-28)and the median(range)follow-up time was 35.2 months(7.2-95.4).Two patients presented stricture after CBD reinsertion into the resection cavity;one was treated with radiologically-guided dilatation and the other underwent revisional Roux-en-Y *** patients presented alkaline reflux gastritis(37.5%),one(12.5%)cholangitis and one CBD stricture after FP with *** risk factors for secondary CBD stricture were ***:As part of a biliary derivation,the FP gave good *** did not observe any complications specifically relat

关键词： common bile duct stricture chronic pancreatitis Frey procedure pancreatectomy

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Combined radiologic and endoscopic treatment(using the “rendezvous technique”) of a biliary fistula following left hepatectomy

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World Journal of Gastroenterology 2016年第30期22卷 6955-6959页

作者： Aurélien Gracient lionel rebibo Richard Delcenserie Thierry Yzet Jean-Marc Regimbeau Service de Chirurgie Digestive H?pital Sud CHU d'Amiens Avenue René LaennecF-80054 Amiens cedex 01 France Department of Gastroenterology Amiens University Hospital Avenue René Laennec F-80054 Amiens cedex 01 France Department of Radiology Amiens University Hospital Avenue René Laennec F-80054 Amiens cedex 01 France EA4294 Jules Verne University of Picardie F-80054 Amiens cedex 01 France Clinical Research Center Amiens University Hospital Avenue René Laennec F-80054 Amiens cedex 01 France

Despite the ongoing decrease in the frequency of complications after hepatectomy, biliary fistulas still occur and are associated with high morbidity and mortality rates. Here, we report on an unusual technique for managing biliary fistula following left hepatectomy in a patient in whom the right posterior segmental duct joined the left hepatic duct. The biliary fistula was treated with a combined radiologic and endoscopic procedure based on the "rendezvous technique". The clinical outcome was good, and reoperation was not required.

关键词： Left hepatectomy Rendezvous technique biliary stent biliary fistula Anatomic variation

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Predictive Factors of Bladder Tumor Recurrence after Nephro-Ureterectomy for Urothelial Carcinoma

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Journal of Cancer Therapy 2015年第2期6卷 122-128页

作者： John David rebibo Emeric Lacarrière Francois Xavier Nouhaud Athmane Safsaf Romain Caremel Christian Pfister Department of Urology Rouen University Hospital Rouen France

Objectives: To evaluate the incidence of bladder cancer after nephro-ureterectomy (NUT) and determine the potential risk factors of bladder recurrence in patients with upper urinary tract urothelial carcinoma (UUT-UC). Materials and Methods: We retrospectively assessed 37 patients with UUT-UC including a significant follow-up after NUT of 34 months (range 12 - 120 months). The median age of the population was 72 years (range 48 - 83 years). Patients with a previous history of bladder cancer, concomitant diagnosis of bladder tumor and UUT-UC;or a metastatic UUT-UC were excluded from the study. Results: Out of these 37 patients, 17 presented a bladder recurrence within an average time of 12 months (range 3 to 31 months) after the NUT. In 94% of the cases, bladder recurrence occurred within the first 24 months following the NUT. Histological distribution was: 13 Ta tumors (76%), 2 pT1 tumors (11.7%);11 patients had a high stage lesion (76%), whereas 4 patients had a low stage lesion (23.5%). As regards the anatomo-pathological characteristics of the UUT-UC, the supra iliac localization of the tumor is a significant risk factor of bladder recurrence (p = 0.04). Conclusion: Bladder recurrence after NUT occurred frequently and could have possibly been under-estimated. The use of intra-vesical instillation of Mitomycin C after NUT has been recently recommended by the European Association of Urology, but no predictive factors have yet been identified. Early diagnosis of bladder recurrence could certainly have reduced mortality in this patient population.

关键词： Bladder Recurrence Nephro-Ureterectomy Urothelial Carcinoma

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Should we use full analgesic dose of opioids for organ procurement in brainstem dead?

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World Journal of Meta-Analysis 2021年第1期9卷 51-53页

作者： Philippe Charlier John-David rebibo Nadia Benmoussa Laboratory Anthropology ArchaeologyBiology(LAAB)Paris-Saclay UniversityMontigny-Le-Bretonneux 78180France Department of Urology Hôpital PrivéArmand BrillardNogent-sur-Marne 94052France Department of ENT Gustave-Roussy InstituteVillejuif 94805France

Families facing the growing demand for organ removal from their loved ones are questioning the possible suffering of the brainstem dead patient.A frequent question they ask to coordinating doctors is:Are you sure he will not feel anything?Currently due to the risk of exacerbation of spinal reflexes and abnormal movements following surgical stimuli,it is recommended to use a curarization and an analgesic agent(most often morphine).The doses of opioids are less important than during usual anaesthesia,whereas the person is considered brainstem dead and there is no longer any cerebral integration of the *** what assures us that absolutely no more sensibility exists at this precise moment?Should the use of full analgesic dose of opioids not be continued anyway?Could this make the levies more"ethical"?

关键词： Bioethics Transplantation Anaesthesiology Brainstem dead

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