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Biomedical subjects

C Meyer

Publications and source records attributed to C Meyer.

At least 649 records · Page 36Linked to original sources
PubMedDate not supplied

[Comparative study of pancreatic resections and drainage procedures in the treatment of chronic pancreatitis. Experience with 145 cases (author's transl)].

The authors report on 145 cases treated surgically for chronic pancreatitis. 128 cases were operated on principle for association of pain and weight loss, 17 cases under necessity for complications. Surgical procedures were most often pancreatico-duodenectomies (75 cases), left pancreatectomies (34 cases) or rarely total pancreatectomies (4 cases), more rarely wirsungo-jejunostomies (32 cases). Choice of surgical procedures were based on anatomical and clinical arguments, but mainly on E.R.C.P. Post-operative mortality, was 8.2% after pancreatic resections and 3.7 after pancreatico-jejunostomies. Secondary mortality were respectively 13% and 11.5%. The overall mortality was 21% after resection and 15% after drainage. Late fonctional results (after 5 years) were in favour of resection (good results 51%). After drainage (good results 22%) initial good results deteriored with time.

Adult↗
PubMedDate not supplied

[Hartmann's operation. Results in 96 cases and present indications].

The results of 96 Hartmann's operations performed over a period of 10 years are analyzed. Surgery was indicated for cancer in 72 p. cent of cases, the objective being palliative treatment in one ouf of two patients, for perforating necrotizing lesions of the colon in 11 p. cent, and for complications of sigmoid diverticulitis in 7 p. cent. Emergency intervention was necessary in 41 p. cent of cases. Overall mortality was 19 p. cent, half of these being related to the original lesion and the other half to complications due to the primary peritonitis. Re-establishment of intestinal continuity was possible in 15 p. cent of patients, must of whom had been operated upon initially for benign lesions. Postoperative mortality was nil in this group. Hartmann's operation should be employed mainly when abdominoperineal and anterior rectal resections are contraindicated. It is principally indicated for palliative treatment of rectal or rectosigmoid cancers, and for benign or malignant tumors with colonic sceptical complications.

Adult↗
PubMedDate not supplied

[Pancreatic cancer. An appraisal of 147 cases (author's transl)].

Out of 147 exocrine cancers of the pancreas 17 (11.6%) were considered as inoperable. Extensive lesions are frequent: liver metastasis (33%) invasion of surrounding tissues (duodenum-portal vein - mesenteric vessels) 29%, regional lymph nodes metastases (25%), peritoneal carcinomatosis (13%). For these reasons, non curative operations were the most frequent: bilio-intestinal anastomosis (56.4%), exploratory laparotomy (14.9%). Our resection rate is low: 16% (21 cases), with performance of 15 pancreatico-duodenal resections (71%), 5 total pancreatectomies (24%) and 1 left pancreatic resection. We note a mortality rate of 19%: 20% four resections, 17% after palliative anastomosis. The mean survival rate was 11.5 months following pancreatico duodenal resections and 4,8 months following anastomotic procedures. No survival after 5 years is registered.

Adult↗
PubMedDate not supplied

Analytical study and long-term results of 230 highly selective vagotomies for chronic duodenal ulcer.

230 highly selective vagotomies (H.S.V.) for chronic duodenal ulcer are carefully studied. Per and postoperative complications are reviewed and compared with the most important reported statistics. A 10-year follow-up gives an indication of the late functional results and evaluation of the percentage of recurrences which lies at around 6%, on first estimation. A complete study of pre- and postoperative gastric secretion tests in duodenal ulcers which did not respond to treatment with Cimetidine and also in patients with very severe hyperacidity is reported, showing that, even in these cases, H.S.V. notably decreases acidity levels and gives satisfactory results. H.S.V. has practically no mortality, a very low morbidity and is followed by excellent functional results. The only factor which remains is the relatively high rate of recurrence which increases with time.

Adult↗
PubMedDate not supplied

[Agenesia of the gallbladder. Report of two new cases (author's transl)].

A propos 2 personal cases of a rare malformation, agenesia of the gallbladder, the authors reappraise the anomaly, of which the precise diagnosis is essentially surgical. They stress the frequency of associated malformation and the usefulness of operative exploration with cholangiography. There is no specific treatment for this condition. Draining the principle bile duct is warranted in case of choledocotomy.

Cholangiography↗
PubMedDate not supplied

[Severe digestive hemorrhage from ulcers on the posterior surface of the first part of the duodenum: clinical aspects and therapeutical results in 107 cases (author's transl)].

The mode of onset, and clinical, radiological, and endoscopic findings in 107 cases of digestive hemorrhage are described, as well as variations in the period elapsing between onset and surgical intervention. Indications for surgery and the results obtained are analyzed. Operation consisted of subdiaphragmatic truncal vagotomy in 74 cases (followed by pyloroplasty in 68 and gastroenterostomy in 6 cases), gastroduodenal resection in 23 cases (with subsequent gastrojejunal anastomosis in 17 and gastroduodenal anastomosis in 6 cases), resection for exclusion operation as described by Finsterer in 8 patients, and highly selective vagotomy with pyloroplasty in 2 cases. Hemorrhage reoccurred in 12 patients (11.2 p. cent), after vagotomy and pyloroplasty in 11 patients (with 3 deaths), and one case after resection. Of the 8 early relapses, 4 were treated medically, leading to 2 recoveries and 2 deaths, the other 4 patients being treated by gastroduodenal resection, with subsequent recovery in 5 cases and one death. The 4 patients with late recurrences were successfully treated medically (2 cases) or surgically (2 cases). Though Weinberg's operation can still be considered as the basic operation in patients with hemorrhage from ulcers on the posterior in patients with hemorrhage from ulcers on the posterior wall of the duodenum, immediate gastric resection is still a valid procedure for large ulcers with thickened walls. Early relapse of hemorrhage after Weinberg's operation should be treated by resection.

Adult↗
PubMedDate not supplied

[Indications and long term results after surgical treatment for necrotic acute pancreatitis (author's transl)].

A series of 50 patients with acute pancreatitis, all complicated by necrosis and hemorrhage, is presented. Cases are broken down into 3 main categories depending on clinical and laboratory data. Thirty-nine partial pancreatectomies and 11 excisions of necrotic tissue were performed. Operative mortality is 36%. Causes of death and morbidity were analysed. Are discussed modalities of surgery from clinical and intraoperative findings. Surgical procedure is completed by generous washings of the abdominal cavity followed by continuous drainage. External biliary diversion is assumed by mews of choledocostomy. Surgical procedure is to be adapted to local conditions because a too systemic attitude is dangerous and possibly responsible of over treatment complications. Postoperative clinical behavior is of great importance when one know that reoperatives in such difficult situation are frequent.

Acute Disease↗
PubMedDate not supplied

[Intra- and sub-peritoneal effusions of barium. A report on 16 cases (author's transl)].

The authors report 16 cases of intra or retro-peritoneal effusion of barium due to colorectal or gastroduodenal perforations. Possible mechanisms and the consequences of barium loss are discussed. Treatment must be directed towards repair of the visceral perforation, usually in the colon or rectum, employing exteriorization or resection but without initial anastomisis, and must treat associated peritonitis by very careful extensive cleaning of the peritoneal cavity. In certain well-defined cases, sub-peritoneal perforation can be treated conservatively. The high mortality rate of about 40% can be explained by the particular type of bacterial potentiation due to barium sulfate. Preventive measures are outlined, including the use of water soluble contrast media in some selected cases.

Aged↗