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Consequences of metabolic syndrome on postoperative outcomes after pancreaticoduodenectomy

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 bMI > 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

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Testing for hepatitis b virus alone does not increase vaccine coverage in non-immunized persons

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World Journal of Gastroenterology 2017年第38期23卷 7037-7046页

作者： Anders boyd Julie bottero Fabrice Carrat Joel Gozlan Hayette Rougier Pierre-Marie Girard Karine Lacombe Institute Pierre Louis d’épidémiologie et de SantéPublique(IPLESP UMRS 1136) INSERMSorbonne Universités Service de maladies infectieuses Hopital Saint-AntoineAP-HP Département de santépublique Hopital Saint-AntoineAP-HP Laboratoire de Virologie Hopital Saint-AntoineAP-HP INSERM UMR_S1135 CIMI

AIM To determine whether hepatitis b virus(HbV)-testing could serve as a gateway to vaccinate non-immunized individuals in a low-prevalent *** Non-immunized subjects participating in a multi-center, HbV-testing campaign in Paris, France were identified and contacted via telephone 3-9 mo after testing in order to determine vaccination status. Vaccination coverage was evaluated in per-protocol(for all respondents) and intent-to-treat analysis(assuming all non-responders did not vaccinate).reSULTS In total, 1215/4924(24.7%) enrolled subjects with complete HbV serology were identified as nonimmunized and eligible for analysis. There were 99/902 successfully contacted subjects who had initiated HbV vaccination after screening: per-protocol, 11.0%(95%CI: 9.0-13.2); intent-to-treat, 8.2%(95%CI: 6.7-9.8). In multivariable analysis, vaccination was more likely to be initiated in individuals originating from moderate or high HbV-endemic countries(P re coverage(P = 0.01) and men who have sex with men(P = 0.02). When asked about the reasons for not initiating HbV vaccination, the most frequent response was "will be vaccinated later"(33.4%), followed by "did not want to vaccinate"(29.8%), and "vaccination was not proposed by the physician"(21.5%). Sub-group analysis indicated a stark contrast in vaccination coverage across centers, ranging from 0%-56%.CONclUSION HbV-vaccination after HbV screening was very low in this study, which appeared largely attributed to physician-patient motivation towards vaccination. Increased vaccination coverage might be achieved by emphasizing its need at the organizational level.

关键词： Health service organization Hepatitis b virus vaccination Public health Testing intervention Vaccine coverage

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Low-intensity extracorporeal shock wave therapy for Peyronie’s disease:a single-center experience

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Asian Journal of Andrology 2022年第1期24卷 45-49页

作者： Maher Abdessater William Akakpo Anthony Kanbar Jérome Parra Thomas Seisen Emmanuel Chartier-Kastler Sarah J Drouin Morgan Roupret APHP-Sorbonne University PitiéSalpêtrièreAcademic Urology Unit83 bvd HopitalParis 75013France

The aim of this article is to assess the outcomes of a low-intensity extracorporeal shock wave therapy(LiESWT)protocol for the treatment of Peyronie’s disease(PD).Patients treated for PD were prospectively recorded,and data were retrospectively ***,characteristics of fibrous plaques,concomitant treatments,International Index of Erectile Function(IIEF-5),Lue score,and pain score on Likert scale were *** in acute phase of PD and an angulation ofre *** protocol consisted of 6 weekly sessions of 4000 pulses each,applied from different directions,with a maximal power of 20 W and 8 Hz *** included 39 patients(median age:56.8 years,interquartile range[IQR]:35.8–62.2 years).The median number of sessions received per patient was *** treatment,the median Lue score decreased from 6.8 initially to 3.3(P=0.003),the median Likert pain score dropped from 1.8 to 0.7(P=0.004),the median plaque size was reduced from 2 cm to 1.2 cm(P=0.08),and the median penile curvature diminished from 31°to 17°(P=0.07).On univariate and multivariate analysis,the only predictors of success were younger age(odds ratio[OR]=0.95,P=0.03 and OR=0.91,P=0.04,respectively)and concomitant use of phosphodiesterase-5 inhibitors(PDE5i;OR=0.92,P=0.02 and OR=0.93,P=0.01,respectively).LiESWT had a favorable impact on Lue score and notably penile pain,curvature,plaque size,and erectile function in patients treated for PD during the early inflammatory phase,with no side *** age and concomitant use of PDE5i were the only success predictors.

关键词： erectile dysfunction extracorporeal shock wave therapy Peyronie’s disease piezoelectric waves

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Sexual health and fertility for individuals with inflammatory bowel disease

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World Journal of Gastroenterology 2019年第36期25卷 5423-5433页

作者： Romain Leenhardt Pauline Riviere Patrick Papazian Isabelle Nion-Larmurier Guillaume Girard David Laharie Philippe Marteau Sorbonne Universite Hepatologie Gastroenterologie et Saint Antoine IBD NeTwork APHP Hopital St Antoine Paris 75012 Ile-de-France France CHU de bordeaux Hopital Haut-Leveque Service d'Hepatogastroenterologie CMC Magellan Bordeaux 33604 Pessac France hopital bichat Service des maladies infectieuses et tropicales APHP Paris 75018 France Service de gynecologie obstetrique Hopital Armand Trousseau Paris 75012 Ile-de-France France

The impact of a chronic disease such as inflammatory bowel disease (IbD) on sexual functioning and body image can significantly impair the quality of life of patients. This review considers the sexual and fertility aspects of IbD patients and their daily management. Modern IbD healthcare management should include appropriate communication on sexuality and consider psychological, physiological, and biological issues. Patients with IbD have less children than the general population, and voluntary childlessness is frequent. The most influential factors reported by IbD patients who experience fertility alteration are psychological and surgery-related problems. Pregnancy is a major concern for patients, and any pregnancy for IbD patients should be closely followed-up to keep the chronic disease in a quiescent state. Preconceptional consultation is of great help.

关键词： Inflammatory bowel disease Crohn’s disease Ulcerative colitis Fertility Pregnancy Sexuality

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How antithymocyte globulin,a polyclonal soup of the past century,when carefully dosed,has become crucial for hematopoietic stem cell transplantation with haplo-identical donors in the 21st century

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Science bulletin 2021年第24期66卷 2445-2447页

作者： Norbert claude Gorin Department of Hematology and Cell Therapy Hopital Saint Antoine and Paris Sorbonne UniversityParis 75012France

Hematopoeitic stem cell transplantation(HSCT)using a haploidentical family donor(HAPLO)was long thought to be non-feasible,essentially because of HLA incompatibility leading to graft rejection,severe acute(aGVH)and chronic(cGVH)graft versus host disease(GVH),severe infections and unacceptable nonrelapse mortality(NRM).The group in Perugia in the last decade of the past century[1],was the first to be successful by initiating a positive selection of CD34+cells from peripheral blood stem cell(PbSC)collections,providing T cell depleted grafts with very high doses of CD34+cells to be *** combined with intensive conditioning regimen and profound immunosuppression,the Perugia group obtained the first demonstration of feasibility and *** later improved their results in acute myeloid leukemia(AML)by showing that a mismatch for natural killer(NK)cells in the killer-cell immunoglobulin-like receptor(KIR)-human leukocyte-antigen class I(HLA1)donor to recipient direction[2]decreased considerably the relapse incidence(RI).Unfortunately this approach was associated with severe infections,a high NRM and in addition was cumbersome and difficult to reproduce in other non-expert centers.

关键词：造血干细胞移植 acute doses

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Laparoscopic liver resection for living donation: Where do we stand?

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World Journal of Gastroenterology 2014年第42期20卷 15590-15598页

作者： Fran?ois Cauchy Lilian Schwarz Olivier Scatton Olivier Soubrane Service de Chirurgie Hépato-bilio-Pancréatique et Transplantation Hépatique H?pital Saint-Antoine Assistance Publique - H?pitaux de Paris Department of HPb Surgery and Liver Transplantation Hopital Beaujon

In Western countries, living donor liver transplantation (LDLT) may represent a valuable alternative to deceased donor liver transplantation. Yet, after an initial peak of enthusiasm, reports of high rates of complications and of fatalities have led to a certain degree of reluctance towards this procedure especially in Western countries. As for living donor kidney transplantation, the laparoscopic approach could improve patient’s tolerance in order to rehabilitate this strategy and reverse the current trend. In this setting however, initial concerns regarding patient’s safety and graft integrity, need for acquiring surgical expertise in both laparoscopic liver surgery and living donor transplantation and lack of evidence supporting the benefits of laparoscopy have delayed the development of this approach. Similarly to what is performed in classical resectional liver surgery, initial experiences of laparoscopy have therefore begun with left lateral sectionectomy, which is performed for adult to child living donation. In this setting, the laparoscopic technique is now well standardized, is associated with decreased donor blood loss and hospital stays and provides graft of similar quality compared to the open approach. On the other hand laparoscopic major right or left hepatectomies for adult-adult LDLT currently lack standardization and various techniques such as the full laparoscopic approach, the hand assisted approach and the hybrid approach have been reported. Hence, even-though several reports highlight the feasibility of these procedures, the true benefits of laparoscopy over laparotomy remain to be fully assessed. This could be achieved through standardization of the procedures and creation of international registries especially in Eastern countries where LDLT keeps on flourishing.

关键词： Liver transplantation Laparoscopy Living donation Postoperative course

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肺动脉高压的诊断与治疗

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中华结核和呼吸杂志 2008年第5期31卷 325-329页

作者： Marc Humbert 申玉静(译) 荆志成(译) Service de Pneumologie et R6animation respiratoire Hopital Antoine-BéclèreUnìversìté Parìs-SudAssìstance Publique-HSpìtaux de ParisClamartFrance 中国医学科学院阜外心血管病医院

肺动脉高压是一组经肺循环阻力增高为主要特征的异源性疾病，近十余年来，国外在此领域取得了突飞猛进的发展，包括发病机制、病理生理机制、分类、诊断方法、严重程度的判断及治疗手段等，并制定了《肺动脉高压诊断和治疗指南》。我国... 详细信息

肺动脉高压是一组经肺循环阻力增高为主要特征的异源性疾病，近十余年来，国外在此领域取得了突飞猛进的发展，包括发病机制、病理生理机制、分类、诊断方法、严重程度的判断及治疗手段等，并制定了《肺动脉高压诊断和治疗指南》。我国虽然在此方面的研究起步较晚。起点水平较低，但通过中华医学会和各级医生的不懈努力，近年来该领域的研究也有了很大进展，本刊已在2007年第9期发表了数篇国内学者撰写的述评和专题笔谈。近日，本刊收到了由法国巴黎大学教授，贝克莱医院呼吸和重症监护科MarcHumbert博士撰写的有关肺动脉高压的专题笔谈，此文的许多观点与国内学者的认识接近或一致，本期将其全文刊出。以使读者正确了解和评价国内学者在该领域的研究水平和进展。

关键词：肺动脉高压诊断方法治疗指南病理生理机制专题笔谈肺循环阻力中华医学会发病机制

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Predictive factors for survival and score application in liver retransplantation for hepatitis C recurrence

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World Journal of Gastroenterology 2016年第18期22卷 4547-4558页

作者： Alice Tung Wan Song Rodolphe Sobesky Carmen Vinaixa Jérome Dumortier Sylvie Radenne Francois Durand Yvon Calmus Géraldine Rousseau Marianne Latournerie Cyrille Feray Valérie Delvart bruno Roche Stéphanie Haim-boukobza Anne-Marie Roque-Afonso Denis Castaing Edson Abdala Luiz Augusto Carneiro D’Albuquerque Jean-Charles Duclos-Vallée Marina berenguer Didier Samuel INSERM Unit 785 Villejuif 94800France Liver and Digestive Organ Transplantation Division Gastroenterology DepartmentUniversity of Sao Paulo Medical SchoolSao Paulo 05403-900Brazil Universite Paris-Sud Villejuif 94800France Liver Transplantation Laboratory LIM-37 Sao Paulo 01246-903Brazil AP-HP hopital Paul brousse Villejuif 94800France La Fe Hospital University of Valencia and CiberehdValencia 46026Spain hopital Edouard Herriot Lyon 69003France hopital Croix Rousse Lyon 69004France AP-HP hopital beaujon Clichy 92110France AP-HP hopital St antoine Paris 75011France AP-HP hopital Salpetriere Paris 75013France CHU Pontchaillou Rennes 35000France AP-HP hopital Henri Mondor Creteil 94010France Viral Hepatitis Laboratory LIM-47 Sao Paulo 01246-903Brazil

AIM: To identify risk factors associated with survival in patients retransplanted for hepatitis C virus(HCV) recurrence and to apply a survival score to this ***: We retrospectively identified 108 patients retransplanted for HCV recurrence in eight European liver transplantation centers(seven in France, one in Spain). Data collection comprised clinical and laboratory variables, including virological and antiviral treatment data. We then analyzed the factors associated with survival in this population. A recently published score that predicts survival in retransplantation in patients with hepatitis C was applied. because there are currently no uniform recommendations regarding selection of the best candidates for retransplantation in this setting, we also described the clinical characteristics of 164 patients not retransplanted, with F3, F4, or fibrosing cholestatic hepatitis(FCH) post-first graft presenting with hepatic decompensation. reSULTS: Overall retransplantation patient survival rates were 55%, 47%, and 43% at 3, 5, and 10 years, respectively. Patients who were retransplanted for advanced cirrhosis had survival rates of 59%, 52%, and 49% at 3, 5, and 10 years, while those retransplanted for FCH had survival rates of 34%, 29%, and 11%, respectively. Under multivariate analysis, and adjusting for the center effect and the occurrence of FCH, factors associated with better survival after retransplantation were: negative HCV viremia before retransplantation, antiviral therapy after retransplantation, non-genotype 1, a Model for End-stage Liver Disease(MELD) score replaced on the waiting list, and a retransplantation donor age bers were small, in the context of the new antivirals era, we showed that outcomes in patientswho underwent retransplantation with undetectable HCV viremia did not depend on donor age and MELD score. The Andrés score was applied to 102 patients for whom all score variables were available,

关键词： Antivirals Hepatitis C Mortality Prognosis retransplantation Risk factors

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real case of primitive embryonal duodenal carcinoma in a young man

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World Journal of Gastroenterology 2017年第4期23卷 730-734页

作者： Julien barbieux Riccardo Memeo Vito De blasi Sebastian Suciu Vanina Faucher Gerlinde Averous Catherine Roy Jacques Marescaux Didier Mutter Patrick Pessaux Hepato-biliary and Pancreatic Surgical Unit IRCAD-IHUUniversity of StrasbourgPlace de l'Hopital Department of Gastroenterology NHCUniversity of StrasbourgPlace de l'Hopital Department of Radiology NHCUniversity of StrasbourgPlace de l'Hopital Department of Pathology NHCUniversity of StrasbourgPlace de l'Hopital

We report here the case of a young man suffering from a rare germ cell tumour. The patient was a 25-year-old man who was referred to our centre for asthenia, stinging epigastric pain, and an iron deficiency anaemia. Gastroscopy revealed a circumferential vegetating lesion on the second portion of the duodenum. The lesion was indurated at the third portion of the duodenum, responsible for a tight stenosis. A computerized tomography-scan of the chest, abdomen and pelvis, and a pancreatic MRI showed a circumferential lesion with a bi-ductal dilatation (i.e., of the common bile duct and Wirsung’s duct) without metastatic localisation. The patient underwent a pancreaticoduodenectomy with lymph node dissection including all cellular adipose tissues of the hepatic pedicle from the hepatic common artery and of the retroportal lamina. Histological findings were suggestive of a duodenal embryonal carcinoma with pancreatic infiltration. This is the second published case highlighting the duodenal primitive localisation of an embryonal carcinoma with pancreatic infiltration.

关键词： Embryonal carcinoma Germ cell tumour Duodenum Young male Pancreaticoduodenectomy

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COVID-19 pandemic,as experienced in the surgical service of a district hospital in Spain

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World Journal of clinical Cases 2021年第23期9卷 6582-6590页

作者： Francisco Javier Pérez Lara Maria belen Jimenez Martinez Francisco Pozo Muñoz Andres Fontalba Navas Rogelio Garcia Cisneros Maria Jose Garcia Larrosa Ignacio Garcia Delgado Maria del Mar Callejon Gil Department of Surgery Hopital de AntequeraAntequera 29200MálagaSpain North Malaga Healthcare District Hopital de AntequeraAntequera 29200MálagaSpain

The coronavirus disease 2019,which is caused by severe acute respiratory syndrome coronavirus 2,was first identified in December 2019 in Wuhan,China,and has since spread rapidly,evolving into a full-blown *** would like to report our experience after 1 year of this pandemic in the surgical service of a district hospital in *** have been many changes(including new protocols)that our service and the hospital have undergone,to adapt to the new *** believe that this experience can be useful for other professionals who have lived and are living a similar situation.

关键词： COVID-19 Hospital Experience Surgery Service Treatment

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