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

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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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Multidisciplinary management of Mirizzi syndrome with cholecystobiliary fistula: the value of minimally invasive endoscopic surgery

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Hepatobiliary & Pancreatic Diseases International 2015年第5期14卷 543-547页

作者： Fabien Le Roux Charles Sabbagh Brice Robert Thierry Yzet Laurent Dugue jean-Paul Joly jean-marc regimbeau Department of Digestive and Oncological Surgery Amiens University Hospital Jules Verne University of Picardie Department of Interventional and Diagnostic Imaging Amiens University Hospital Jules Verne University of Picardie Department of Digestive Surgery Saint-Camille Hospital Department of Hepatogastroenterology Amiens University Hospital Jules Verne University of Picardie

Mirizzi syndrome, a rare complication of gallstones, is defined by obstruction of the main bile duct. This obstruction may worsen and thus result in cholecystobiliary fistula. Surgical management of Mirizzi syndrome is complicated by the presence of inflamed tissue around the hepatic pedicle, making it impossible to distinguish between the main bile duct and the gallbladder. The surgeon＇s first task is to perform subtotal cholecystotomy（from the fundus of the gallbladder to the neck） without trying to locate the cystic duct. In a second step, the gallstones are extracted and the main bile duct is then repaired. In most cases, a T-tube is used to drain the main bile duct, and abdominal drainage is left in place（in case a bile fistula forms）. This study concluded that preoperative drainage of the main bile duct in the treatment of Mirizzi syndrome types II and III is feasible and might help to decrease the postoperative complication rate.

关键词： jaundice Mirizzi syndrome cholecystobiliary fistula endoscopic treatment cholecystectomy T-tube drain

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Impact of homogeneous pathologic response to preoperative chemotherapy in patients with multiple colorectal liver metastases

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World Journal of Gastroenterology 2017年第45期23卷 8027-8034页

作者： Charles Sabbagh Denis Chatelain Christophe Attencourt jean-Paul Joly Bruno Chauffert Cyril Cosse jean-marc regimbeau Depart-ment of Digestive and Oncologic Surgery Amiens University Medical Center INSERM U1088 Jules Verne University of Picardie University of Picardie Department of Anatomic Pathology Amiens University Medical Center Department of Hepatogastroenterology Amiens University Medical Center Department of Medical Oncology Amiens University Medical Center EA4294 Jules Verne University of Picardie

AIM To analyze the homogeneity of pathologic response to preoperative chemotherapy(PRPC) after chemotherapy in patients with multiple liver metastases(LM).METHODS From September 2011 to August 2014,patients with at least two LM undergoing preoperative chemotherapy prior to resection were included in this retrospective,single-center study. The endpoints were PRPC homogeneity(according to both the Rubbia-Brandt and MD Anderson classifications),the impact of PRPC on the MDT decision,factors associated with homogeneous PRPC and overall survival of patients with vs. without homogeneous *** seventy-three patients with a total of 88 liver resections(including 15 two-stage procedures) were included in the study. The homogeneous PRPC rate was 55% according to the Rubbia-Brandt classification and 53% according to the MD Anderson classification. The MDT decision was modified by the PRPC in only 2.7% of patients(n = 2). CONCLUSION The PRPC was homogeneous in only one half of patients and had very little influence on the MDT decision.

关键词：肝转移病理学的反应同质外科手术前的化疗 Colorectal 癌症

Prognostication algorithm for non-cirrhotic non-B non-C hepatocellular carcinoma-a multicenter study under the aegis of the French Association of Hepato-Biliary Surgery and liver Transplantation

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Hepatobiliary Surgery and Nutrition 2023年第2期12卷 192-204,I0002-I0004页

作者： Charlotte Maulat Stéphanie Truant Christian Hobeika Louise Barbier Astrid Herrero Alexandre Doussot Johan Gagnière Édouard Girard Hadrien Tranchart jean-marc regimbeau David Fuks François Cauchy Mathieu Prodeau Antoine Notte Cyprien Toubert Ephrem Salamé Mehdi El Amrani Sandrine Andrieu Fabrice Muscari Jason Shourick Bertrand Suc Department of Digestive Surgery Hepatobiliary and Pancreatic Surgery and Liver Transplantation UnitToulouse University HospitalToulouseFrance Department of Digestive Surgery and Transplantation Claude-HuriezHospitalCHRU LilleLilleFrance CANTHER laboratory“Cancer Heterogeneity Plasticity and Resistance to Therapies”Inserm UMR-S1277 Teams“MucinsCancer and Drug Resistance”LilleFrance Department of Hepato-bilio-pancreatic Surgery and Liver Transplantation Beaujon HospitalAPHPClichyFrance Department of Digestive Surgery and Liver Transplantation Trousseau HospitalTours University HospitalToursFrance Department of Digestive Surgery and Liver Transplantation Saint Eloi HospitalMontpellier University HospitalMontpellierFrance Department of Digestive Surgery and Liver Transplantation Besançon University HospitalBesançonFrance Department of Digestive and Hepatobiliary Surgery University Hospital of Clermont-FerrandClermont-FerrandFrance U1071 Inserm/UniversitéClermont-Auvergne Clermont-FerrandFrance Department of Digestive Surgery and Emergency CHU Grenoble-AlpesGrenobleFrance Department of Mini-invasive Surgery Antoine Béclère HospitalAPHPClamartFrance Department of Digestive Surgery Amiens Picardie University Hospital and Picardie Jules Verne UniversityAmiensFrance Department of Digestive Surgery Institut Mutualiste MontsourisParisFrance Department of Epidemiology Toulouse University HospitalToulouseFrance

Background:Liver resection and local ablation are the only curative treatment for non-cirrhotic hepatocellular carcinoma(HCC).Few data exist concerning the prognosis of patients resected for non-cirrhotic *** objectives of this study were to determine the prognostic factors of recurrence-free survival(RFS)and overall survival(OS)and to develop a prognostication algorithm for non-cirrhotic ***:French multicenter retrospective study including HCC patients with non-cirrhotic liver without underlying viral hepatitis:F0,F1 or F2 ***:A total of 467 patients were included in 11 centers from 2010 to ***-cirrhotic liver had a fibrosis score of F0(n=237,50.7%),F1(n=127,27.2%)or F2(n=103,22.1%).OS and RFS at 5 years were 59.2%and 34.5%,*** multivariate analysis,microvascular invasion and HCC differentiation were prognostic factors of OS and RFS and the number and size were prognostic factors of RFS(P10 cm(n=176,Group 2);>2 HCC regardless of size Conclusions:We developed a prognostication algorithm based on the number(≤or>2)and size(≤or>10 cm),which could be used as a treatment decision support concerning the need for perioperative *** case of bifocal HCC,surgery should not be a contraindication.

关键词： Hepatocellular carcinoma(HCC) non-cirrhotic liver prognostic factors recurrence-free survival(RFS) prognostication algorithm

Restrictive model of compensated carbon tetrachloride-induced cirrhosis in rats

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World Journal of Gastroenterology 2008年第45期14卷 6943-6947页

作者： jean-marc regimbeau David Fuks Niaz Kohneh-Shahri Benot Terris Olivier Soubrane Laboratory of Innovative treatment of Liver Diseases (EA 1833) Université René Descartes Federation of Digestive Diseases Amiens North Hospital University of Picardy place Victor Pauchet Department of Pathology Hpital Cochin Port Royal

AIM: To develop a simplified and quick protocol to induce cirrhosis and standardize models of partial liver resection in ***: In Fischer F344 rats two modified protocols of phenobarbital-carbon tetrachloride (CCl4) (dilution 50%) gavage to induce cirrhosis (frequency adjusted according to weight, but each subsequent dose was systematically administered) were tested, i.e. the rapid and slow protocols. Prothrombin time (PT) and total bili-rubin (TB) were also evaluated. Animals from the rapid group underwent 15% hepatectomy and animals from the slow group underwent 70% ***: Rapid protocol: This corresponded to 1 ga-vage/4 d over 6 wk (mortality 30%). Mean PT was 35.2 ± 2.8 s (normal: 14.5 s), and mean TB was 1.8 ± 0.2 mg/dL (normal: 0.1 mg/dL). Slow protocol: This cor-responded to 1 gavage/6 d over 9 wk (mortality 10%). Mean PT was 11.8 ± 0.2 s (normal: 14.5 s), and mean TB was 0.4 ± 0.04 mg/dL (normal: 0.1 mg/dL). Patho-logical analyses were performed in both protocols which showed persistent cirrhosis at 3 mo. Rat mortality in the rapid gavage group who underwent 15% hepatectomy and in the slow gavage group who underwent 70% hepatectomy was 50% and 70%, ***: Our modified model is a simplified method to induce cirrhosis which is rapid (6 to 9 wk), efficient and stable up to 3 mo. Using this method, "Child Pugh A" or "Child Pugh BC" cirrhotic rats were obtained. Our models of cirrhosis and hepatectomy can be used in various situations focusing on postoperative survival.

关键词：肝硬化肝切除术治疗临床

Procalcitonin and intestinal ischemia:A review of the literature

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World Journal of Gastroenterology 2014年第47期20卷 17773-17778页

作者： Cyril Cosse Charles Sabbagh Sad Kamel Antoine Galmiche jean-marc regimbeau INSERM U1088 Jules Verne University of Picardie80054 AmiensFrance Department of Digestive and Oncological Surgery Amiens University HospitalJules Verne University of PicardiePlace Victor PauchetF-80054 Amiens cedex 01France Clinical Research Center Amiens University Hospital80054 Amiens Cedex 01France Department of Biochemistry Amiens University HospitalJules Verne University of PicardieF-80054 AmiensFrance EA4294 Jules Verne University of PicardieF-80054 AmiensFrance

Intestinal ischemia is common after emergency gastrointestinal or cardiovascular *** present,there are no diagnostic tools for the early diagnosis of intestinal *** the last decade,procalcitonin(PCT)has been suggested as a marker of this ***,we review the use of PCT as a diagnostic tool for intestinal *** reviewers independently searched the Pub Med and EMBASE databases for articles on intestinal ischemia and *** then considered(1)the criteria applicable to preclinical and clinicaldata;and(2)PCT’s predictive value in the diagnosis of intestinal *** quality was rated according to the STAndards for Reporting of Diagnostic *** 1993 and 2014,seven studies(including two preclinical studies and five clinical studies)dealt with the use of PCT to diagnose intestinal ***’s sensitivity,specificity,positive predictive value and negative predictive value ranged between 72%and 100%;68%and 91%;27%and 90%and 81%and 100%,*** area under the receiver operating characteristic curve ranged from 0.77 to *** view of the preclinical and clinical data,we consider that PCT can be used in daily practice as a tool for diagnosing intestinal ischemia.

关键词： Procalcitonin Intestinal Ischemia Diagnosis Review

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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巨块型肝癌术后疗效的重新评价

局解手术学杂志 2000年第2期9卷 196-196页

作者： jean-marc regimbeau ,周志华重庆市第三军医大学学员旅三队

多数肝细胞癌到进展期才被发现,由于癌肿较大,既往研究认为肝切除术治疗的预后不良,不宜采用。为了重新评估手术对巨块型肝细胞癌的疗效,作者分析了法国巴黎大学Beaujon医院于1984～1996年施行的256例肝细胞癌切除病例(无层状纤维化型)... 详细信息

多数肝细胞癌到进展期才被发现,由于癌肿较大,既往研究认为肝切除术治疗的预后不良,不宜采用。为了重新评估手术对巨块型肝细胞癌的疗效,作者分析了法国巴黎大学Beaujon医院于1984～1996年施行的256例肝细胞癌切除病例(无层状纤维化型),包括:①癌肿小于5cm者121例,归为小型肝癌,其中肝硬化(以child-pugh分级为准,下同)96例。②癌肿大于8cm者94例,归为巨块型肝癌,其中肝硬化37例。两型肝癌均

关键词：巨块型肝癌术后疗效