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Hepatobiliary surgery and Nutrition 2022年第5期11卷 718-720页

作者： Charles de Ponthaud sébastien gaujoux Department of Hepato-Biliary and Pancreatic surgery and Liver Transplantation AP-HPPitié-Salpêtrière HospitalParisFrance sorbonne University ParisFrance

This stepped-wedge cluster randomized study(1)included all pancreatectomies performed from 17 Dutch pancreatic surgery centers(all realizing>20 pancreaticoduodenectomies per year)over 22 *** aim was to demonstrate the value of an algorithm for the early diagnosis and management of postoperative *** algorithm determined when to do abdominal computed tomography(CT)scan,radiological drainage,start antibiotic treatment,and remove abdominal *** was calculated every day from postoperative day 3 to *** primary endpoint was a composite of bleeding that required invasive intervention,organ failure and 90-day mortality.

关键词： postoperative diagnosis remove

Consequences of metabolic syndrome on postoperative outcomes after pancreaticoduodenectomy

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World Journal of Gastroenterology 2017年第17期23卷 3142-3149页

作者： Alban Zarzavadjian Le Bian David Fuks sophie Chopinet sébastien gaujoux Manuela Cesaretti Renato Costi Ajay P Belgaumkar Claude smadja Brice Gayet Department of Digestive surgery Centre Hospitalier Simone Veil Laboratory of Medical Ethics and Legal Medicine University Paris Descartes Department of Digestive disease-Institut Mutualiste Montsouris UniversitéParis Descartes Department of Digestive surgery Assistance PubliqueHopitaux de Paris Hopital Cochin Department of Digestive surgery Assistance PubliqueHopitaux de Paris Hopital Antoine Béclère157 rue de la Porte Trivaux Boulevard Général Leclerc

AIM To analyze immediate postoperative outcomes after pancreaticoduodenectomy regarding metabolic *** In two academic centers, postoperative outcomes of patients undergoing pancreaticoduodenectomy from 2002 to 2014 were prospectively recorded. Patients presenting with metabolic syndrome [defined as at least three criteria among overweight(BMI ≥ 28 kg/m2), diabetes mellitus, arterial hypertension and dyslipidemia] were compared to patients without metabolic *** Among 270 consecutive patients, 29(11%) presented with metabolic syndrome. In univariable analysis, patients with metabolic syndrome were significantly older(69.4 years vs 62.5 years, P = 0.003) and presented more frequently with soft pancreas(72% vs 22%, P = 0.0001). In-hospital morbidity(83% vs 71%) and mortality(7% vs 6%) did not differ in the two groups so as pancreatic fistula rate(45% vs 30%, P = 0.079) and severity of pancreatic fistula(P = 0.257). In multivariable analysis, soft pancreas texture(P = 0.001), pancreatic duct diameter 30 kg/m2(P = 0.041) were identified as independent risk factors of pancreatic fistula after pancreaticoduodenectomy, but not metabolic *** In spite of logical reasoning and appropriate methodology, present series suggests that metabolic syndrome does not jeopardize postoperative outcomes after pancreaticoduodenectomy. Therefore, definition of metabolic syndrome seems to be inappropriate and fatty pancreas needs to be assessed with an international consensual histopathological classification.

关键词： soft pancreas Postoperative outcomes Metabolic syndrome Pancreaticoduodenectomy

A rare cause of obstructive jaundice and gastric outlet obstruction

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World Journal of Gastrointestinal surgery 2013年第6期5卷 192-194页

作者： Florence Jeune Gaspard d'Assignies Alain sauvanet sébastien gaujoux Department of Hepato-Pancreato-Biliary surgery Ple des Maladies de l'Appareil Digestif(PMAD)AP-HPBeaujon Hospital92110 ClichyFrance Department of Radiology Ple des Maladies de l'Appareil Digestif(PMAD)AP-HPBeaujon Hospital92110 ClichyFrance University Paris 7 Denis Diderot 75013 ParisFrance

superior mesenteric artery syndrome is a rare cause of upper gastrointestinal obstruction,and is characterized by 3 rd duodenal obstruction between the abdominal aorta and the superior mesenteric *** symptoms are postprandial epigastric pain,nausea,vomiting,and weight loss,or acute upper gastrointestinal *** herein describe an unusual presentation,with jaundice due to compression of the common bile duct by the gastric obstruction and dilated duodenum.

关键词： Upper gastrointestinal obstruction superior mesenteric artery syndrome Obstructive jaundice

Trichobezoar:A rare cause of bowel obstruction

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World Journal of Gastrointestinal surgery 2011年第4期3卷 54-55页

作者： sébastien gaujoux Gaёlle Bach Joyce Au Gaёlle Godiris-Petit Nicolas Munoz-Bongrand Pierre Cattan Emile sarfati Department of Digestive surgery Hpital Saint-LouisAssistance Publique-Hpitaux de Parisand University Paris 775010 ParisFrance Department of Radiology Hpital Saint-LouisAssistance Publique-Hpitaux de Parisand University Paris 775010 ParisFrance Department of surgery Memorial Sloan-Kettering Cancer CenterNew YorkNY 10065United States

A bezoar is an intraluminal mass formed by the accumulation of undigested material in the gastrointestinal tract. A trichobezoar is a bezoar made up of hair and is a rare cause of bowel obstruction of the proximal gastrointes-tinal tract. They are seen mostly in young women with trichotillomania and trichotillophagia and symptoms include epigastric pain, nausea, loss of appetite and bowel or gastric outlet obstruction. We herein describe a case of a trichobezoar that presented as a gastric outlet obstruction and was subsequently successfully removed via a laparotomy.

关键词： Obstruction Bezoar Trichobezoar Tricho- tillomania

Role of staging laparoscopy in peri-pancreatic and hepatobiliary malignancy

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World Journal of Gastrointestinal surgery 2010年第9期2卷 283-290页

作者： sebastien gaujoux Peter J Allen Hepatobiliary service Memorial Sloan-Kettering Cancer Center1275 York AvenueC-887New YorkNY 10021United States

Even after extensive preoperative assessment,staging laparoscopy may allow avoidance of non-therapeutic laparotomy in patients with radiographically occult metastatic or locally unresectable *** laparoscopy is associated with decreased postoperative pain,a shorter hospital stay and a higher likelihood of receiving systemic therapy compared to laparotomy but its yield has decreased with improvements in imaging *** uses of staging laparoscopy include the following:(1) In the staging of pancreatic adenocarcinoma,laparoscopic staging allows for the identif ication of sub-radiographic metastatic disease in locally advanced cancer in approximately 30% of patients and,in radiographically resectable cancer,may identify metastatic disease in 10%-15% of cases;(2) In colorectal liver metastases,selective use of laparoscopic staging in patients with a clinical risk score of over 2 identifies unresectable disease in approximately 20% of patients;(3) In hepatocellular carcinoma,laparoscopic staging could be selectively used in high-risk patients such as those with clinically apparent liver cirrhosis and in patients with major vascular invasion or bilobar tumors;and(4) In biliary tract malignancy,staging laparoscopy may be used in all patients with potentially resectable primary gallbladder cancer and in selected patients with T2/T3 hilar *** of the decreasing yield of sL secondary to improvements in imaging techniques,staging laparoscopy should be used selectively for patients with pancreatic and hepatobiliary malignancy to avoid unnecessary non-therapeutic laparotomy and to improve resource *** individual surgeon should apply his or her threshold as to whether staging laparoscopy is indicated according to the quality of preoperative imaging studies and the availability of resources at their own institution.

关键词： Pancreatic cancer Liver metastasis staging laparoscopy Cholangiocarcinoma Gallbladder cancer Hepatocellular carcinoma

Unveiling hidden outcomes in malignant gastric outlet obstruction research–insights from a"Pancreas 2000"review

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World Journal of Gastrointestinal Endoscopy 2024年第8期16卷 451-461页

作者： Filipe Vilas-Boas Giacomo Emanuele Maria Rizzo Charles De Ponthaud stuart Robinson sebastien gaujoux Gabriele Capurso Giuseppe Vanella Bahadır Bozkırlı Department of Gastroenterology São João University HospitalPorto 4200Portugal Endoscopy service Department of Diagnostic and Therapeutic ServicesScientific Institute for ResearchHospitalization and Healthcare-The Mediterranean Institute for Transplantation and Highly Specialized TherapiesPalermo 90127SiciliaItaly Department of Digestive Hepato-Biliary and Pancreatic Surgery and Liver TransplantationAP-HP Pitié-SalpêtriereSorbonne UniversitéParis 75013Île-de-FranceFrance Department of Hepatobiliary Pancreatic and Transplant SurgeryFreeman HospitalNewcastle NE77DNNewcastle upon TyneUnited Kingdom Division of Pancreato-Biliary Endoscopy and Endosonography Pancreas Translational and Clinical Research CenterIRCCS San Raffaele Scientific InstituteVita-Salute San Raffaele UniversityMilano 20132Italy Department of General surgery HPB-UnitAcıbadem Maslak HospitalIstanbul 34398Türkiye

Malignant gastric outlet obstruction(mGOO)is a major condition affecting patients with periampullary tumors,including pancreatic *** current treatment options include surgical gastroenterostomy,endoscopic stenting and more recently EUs-guided *** studies comparing the outcomes of the three procedures focus on technical success,clinical success and ***“occult”outcomes relevant to the patient’s viewpoints and perspective may ultimately impact on cancer-related and overall survival,such as body mass composition,nutritional biomarkers,chemotherapy tolerance and patient-reported quality of *** aim of this review is to provide an overview of potential key outcomes that should be explored in future comparative research around mGOO treatment options.

关键词： Malignant gastric outlet obstruction Endoscopic ultrasound-guided gastroenterostomy Patient-reported outcomes Body composition Nutrition Quality of life

胰腺术后患者死亡原因分析多中心队列研究(CARE研究)

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肝胆外科杂志 2021年第6期29卷 479-480页

作者： Beugniez C sauvanet A sulpice L gaujoux s Turrini O Truant s schwarz L Piessen G Regimbeau JM Muscari F Adham M Pattou F schneider L Clement G Delpero JR Pruvot FR Mehdi EA 崔笑(摘译) 薛鸿(摘译) 耿小平(审校) French-ACHBT Working Group 不详

虽然近年来胰腺手术技术取得了长足进步,但胰腺术后发生死亡的事件依然仍有发生.本研究分析了法国多个高流量胰腺外科中心2015年1月至2018年12月期间接受胰腺切除术90天内死亡的原因.共9个中心纳入研究患者3195例,术后90天内死亡140例,3... 详细信息

虽然近年来胰腺手术技术取得了长足进步,但胰腺术后发生死亡的事件依然仍有发生.本研究分析了法国多个高流量胰腺外科中心2015年1月至2018年12月期间接受胰腺切除术90天内死亡的原因.共9个中心纳入研究患者3195例,术后90天内死亡140例,39例患者因故排除,有效分析101例.30%的死亡是术前评估或术后管理不善导致,约10%是不恰当的术中决策所致.高龄、联合动脉切除,尤其是计划外手术切除,是死亡相关危险因素.

关键词：胰腺手术胰腺外科胰腺切除术术前评估死亡原因分析计划外相关危险因素术后管理