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Biomedical subjects

G Delvaux

Publications and source records attributed to G Delvaux.

At least 19 recordsLinked to original sources
PubMed2003

Neuroendocrine tumors of the pancreas.

BACKGROUND: The benefits of associating magnetic resonance imaging (MRI) and laparoscopy for localizing and treating neuroendocrine pancreatic tumors (NEPTs) have been poorly documented. METHODS: In a retrospective study, eight patients with a mean age of 48 years were operated on for a NEPT. MRI was used to localize the lesions. In all patients a laparoscopic resection was carried out. Laparoscopic ultrasonography (LUS) was used during most operations. RESULTS: The tumor was clearly localized by MRI in seven patients, and LUS showed the lesion in another patient whose preoperative MRI had been unsuitable. Three enucleations, three spleen-preserving caudal pancreatectomies, and two caudal pancreatectomies with splenectomy were carried out. There were no conversions and the mean operating time was 260 min, with a mean blood loss of 180 ml. The mean hospital stay was 7 days. There were no minor nor major complications during the hospitalization period. However, a pancreatic abscess was diagnosed in one patient 1 month later, requiring an urgent laparotomy. CONCLUSION: MRI as well as LUS are indeed suitable techniques to localize NEPTs. Moreover, the minimally invasive approach ensured an adequate treatment with a more comfortable and short postoperative recovery.

Adult↗
PubMed2002

Laparoscopic repair of diaphragmatic Morgagni hernia.

A novel case of laparoscopic repair of a diaphragmatic hernia through the foramen of Morgagni in a 5-year-old boy is reported. The patient had a prompt and complete recovery, with no evidence of recurrence noted at 1 year after surgery. Laparoscopic repair is considered to be a suitable and safe procedure for the treatment of Morgagni hernia.

Child, Preschool↗
PubMed1999

Laparoscopic management of neuroendocrine tumours of the pancreas.

Neuroendocrine tumours of the pancreas are rare but can be fatal due to excessive secretion of regulatory peptides. The localization of these small tumours can be difficult while open surgical treatment is associated with a relatively high morbidity. Two cases are presented where endocrine tumours of the pancreas were successfully removed by laparoscopy. In the surgical treatment of endocrine pancreatic tumours, the use of laparoscopic techniques can provide a valuable means for localizing the tumour while improving the patient's comfort and decreasing operative morbidity.

Aged↗
PubMed1998

Implantation of standardized beta-cell grafts in a liver segment of IDDM patients: graft and recipients characteristics in two cases of insulin-independence under maintenance immunosuppression for prior kidney graft.

Islet allografts in insulin-dependent diabetic (IDDM) patients exhibit variable survival lengths and low rates of insulin-independence despite treatment with anti-T-cell antibodies and maintenance immunosuppression. Use of poorly characterized freshly isolated preparations makes it difficult to determine whether failures are caused by variations in donor tissue. This study assesses survival of standardized beta-cell allografts in C-peptide negative IDDM patients on maintenance immunosuppression following kidney transplantation and without receiving anti-T-cell antibodies or additional immunosuppression. Human islets were isolated from pancreatic segments after maximal 20 h cold-preservation. During culture, preparations were selected according to quality control tests and combined with grafts with standardized cell composition (> or = 50% beta cells), viability (> or = 90%), total beta-cell number (1 to 2 x 10(6)/kg body weight) and insulin-producing capacity (2 to 4 nmol x graft(-1) x h(-1)). Grafts were injected in a liver segment through the repermeabilized umbilical vein. After 2 weeks C-peptide positivity, four out of seven recipients became C-peptide negative; two of them were initially GAD65-antibody positive and exhibited a rise in titre during graft destruction. The other three patients remained C-peptide positive for more than 1 year, two of them becoming insulin-independent with near-normal fasting glycaemia and HbA1c; they remained GAD65- and islet cell antibody negative. The three patients with surviving grafts presented a history of anti-thymocyte globulin therapy at kidney transplantation. Long-term surviving grafts increased C-peptide release following intravenous glucagon or oral glucose but not following intravenous glucose. Thus, cultured human beta-cells can survive for more than 1 year in IDDM patients on maintenance anti-rejection therapy for a prior kidney graft and without the need for an increased immunosuppression at the time of implantation. The use of functionally standardized beta-cell grafts helps to identify recipient and graft factors which influence their survival and metabolic effects. Insulin-independence can be achieved by injection of 1.5 million beta-cells per kg body weight in a liver segment. These beta-cell implants respond well to adenylcyclase activators but poorly to glucose.

Adolescent↗
PubMed1996

Laparoscopic-assisted surgery of the spleen: clinical experience in expanding indications.

Between January 1993 and November 1995 laparoscopic surgery was used in 21 patients with a variety of splenic diseases, namely idiopathic thrombocytopenic purpura, congenital spherocytosis, lymphoma, leukemic infiltrative disease, splenic infarction, trauma, or splenic cyst. Total splenectomy was carried out laparoscopically in 16 patients. Conversion to open splenectomy was necessary in two other patients because of intractable bleeding. Two patients with a splenic cyst underwent laparoscopic unroofing of the cyst. Conservative hemostasis of a spleen injury grade II was carried out in a child after blunt trauma. The total mean duration of the laparoscopic procedures was 158 min and the mean blood loss volume was 350 ml, both conversions being excluded. Postsurgical recovery was excellent and the average hospital stay was 5 days, including the patients with conversion. There were no significant postoperative complications. Our observations indicate that an increasing number of surgical diseases of the spleen can be managed adequately by a less invasive laparoscopic approach. However, the criteria for using this procedure are in an expanding phase and are still mainly dependent on the surgeon's technical experience.

Adolescent↗
PubMed1996

Increasing serum levels of alpha-fetoprotein in a patient with relapsing gallbladder carcinoma.

Alpha-fetoprotein (AFP) is a useful serum tumor marker especially for hepatocellular carcinoma and yolk-sac tumor. Increased serum levels of AFP have also been found in adenocarcinoma of the stomach, the pancreas, the colon and the lung, and in some squamous cell carcinomas of the lung. We describe a patient with a recurrent gallbladder carcinoma, presenting with increasing serum levels of AFP as the tumor progresses. Remarkable are the histologic changes in the metastases of the tumor, which showed more dedifferentiation as the number of cells containing AFP increased.

Adenocarcinoma, Papillary↗
PubMed1996

Broncho-mediastinal fistula following perforation of the oesophagus.

We present a 63-year old female with mediastinitis following an esophageal perforation, possibly favoured by an oesophageal motility-disorder and the use of non-steroidal anti-inflammatory drugs, who developed a broncho-mediastinal fistula in the left main bronchus. She was successfully treated with intravenous antibiotics, a cervical oesophagostomy and secondary isoperistaltic coloplasty.

Anti-Bacterial Agents↗
PubMed1993

Hepatic artery aneurysm. Case reports with review of the literature.

Two cases of hepatic artery aneurysm are reported. The first presented as obstructive jaundice, the second as an upper gastrointestinal bleeding. The diagnosis was made by performing ultrasound, CT-scan and angiography. In both cases surgery was the treatment. However, in some cases, interventional angiography with embolisation of the affected vessel offers an alternative treatment.

Aged↗
PubMed1993

Transvaginal removal of gallbladders with large stones after laparoscopic cholecystectomy.

Very large gallstones sometimes render laparoscopic cholecystectomy time consuming and difficult. In addition, several advantages of laparoscopy, namely decreased postoperative pain and minimal abdominal scarring, could be compromised by the need to enlarge the umbilical incision. Besides the solution of the mechanical or electrohydraulic fragmentation of such large gallstones, as described by several authors, we propose a posterior colpotomy as a simple technique for removing very large gallbladders in women.

Cholecystectomy, Laparoscopic↗
PubMed1991

Hepatic artery ligation with and without portal infusion of 5-FU. A randomized study in patients with unresectable liver metastases from colorectal carcinoma. The E.O.R.T.C. Gastrointestinal Cancer Cooperative Group (G.I. Group).

The aim of this multicentric prospective randomized clinical trial was to study the efficacy of hepatic artery ligation (HAL) with and without portal infusion (PI) of 5-FU in patients with liver metastasis of colorectal origin. Seventy-four patients were randomized. Sixty-seven were fully evaluable. Thirty-five patients were eligible in the HAL + PI of 5-FU group and 32 in the HAL alone group. The 5-FU infusion had to be discontinued for technical reasons in 13 patients. Complications of HAL were relatively high, including four hepatic failures (WHO grading greater than 2). Side effects of chemotherapy were limited. Five patients out of 30 had a partial response (WHO criteria) and one patient had a complete response in the group treated by HAL and PI of 5-FU. Only one patient had a partial response in the HAL alone group. Median survival for both groups was 12 months. Median time to progression for both groups was 6 months. This study did not show any advantage of delivery using the portal route in addition to hepatic artery ligation in terms of progression nor in survival of patients.

Adenocarcinoma↗
PubMed1990

Restoration of colorectal continuity reverses atrophy in human rectal mucosa.

Cell kinetic activity and adaptive response of rectal mucosa from patients with Hartmann's procedure were studied before and after restoration of colorectal continuity. Patients without colostomy and with normal rectal mucosa were used as controls. Autoradiography of in vitro labeled mucosal samples with [3H]thymidine was used. The proliferative activity in the rectal crypts was estimated by measuring labeling and mitotic indices, total DNA of isolated crypts, and total crypt cell numbers. One hundred forty days after creating a proximal end colostomy, labeling index (P less than 0.05), mitotic index (P less than 0.01), DNA content per crypt (P less than 0.05), and number of cells per crypt (P less than 0.05) decreased significantly compared to control values. Restoration of colorectal continuity resulted in a significant increase of the labeling index (P less than 0.05), the mitotic index (P less than 0.01), the DNA content per crypt (P less than 0.05), and the cell number per crypt (P less than 0.05). There were no significant differences between the postclosure values and the controls. These data indicated that excluding the human rectal mucosa from fecal stream determined a mucosal atrophy that could be reversed by restoration of colorectal continuity.

Aged↗
PubMed1989

Peroperative ultrasonography in the diagnosis of splenic vein thrombosis.

A case of recurrent bleeding from gastric varices due to isolated splenic vein thrombosis is reported. There was no evidence of pancreatic, retroperitoneal or infectious disease. The final diagnosis was made by intraoperative ultrasonography during an emergency laparotomy for massive bleeding from a ruptured gastric vein. Splenectomy is the treatment of choice in this case. The patient was cured after splenectomy.

Adult↗
PubMed1988

Influence of stress on epithelial cell proliferation in the gut mucosa of rats.

Wistar rats were stressed by immobilization in a cold environment during either 2 or 12 h. The animals were killed 1 h after intraperitoneal injection of 3H-thymidine and autoradiography was used. The proliferative parameters were estimated in the mucosa of the stomach after the 2-hour stress period. After the 12-hour stress period, labeling and mitotic indices were measured in the gastric mucosa as well as in the antrum, duodenum, ileum, colon and epidermis. The stress period of 2 h did not induce significant changes of the proliferative parameters in the mucosa of the stomach whereas cell proliferation was significantly inhibited in all examined tissues, including the skin, after the 12-hour stress period. Gastric hemorrhagic lesions were observed only in the oxyntic part of the stomach and occurred as early as 2 h after stress despite there was no change in the proliferative parameters at this time. The lesions became more obvious after the 12-hour stress period. Our observations indicate that inhibition of cell renewal by stress is not the mechanism by which stress erosions develop in the digestive mucosa.

Animals↗
PubMed1987

Regeneration of the femoral artery following experimental end-to-end anastomosis in the rat. An ultrastructural follow-up.

An experimental end-to-end anastomosis of the common femoral artery was performed in 45 adult Wistar rats. The vessel wall condition was assessed at 10 min, 3 days, 1, 2, 4, and 8 weeks following surgery by scanning and transmission electron microscopy. The microsurgical procedure inflicts extensive trauma in all layers of the arterial wall, with a desendothelialization largely surpassing the surgical field. Reendothelialization was completed at 2 weeks. Apparently, and as compared to less damaging vessel wall manipulations, such deep medial and wide endothelial lesions do not retard vessel wall healing to normal functionality. Moreover, the formation of primary atherogenic structures by smooth muscle cell migration to the intima seems restricted.

Animals↗
PubMed1986

Postprandial stimulation of epithelial cell proliferation in defunctioned colon of rats is not caused by gastrin.

Rats were submitted, at random, to either a diverting colostomy alone or to antrectomy with a colostomy. After a 48-h fasting period, animals from each group were refed, whereas control animals were kept fasting. Animals were killed at 0, 6, 12, 18, and 24 h after the time of refeeding. In vitro labeling of colon mucosa with [3H]thymidine and autoradiography were performed to determine the proliferative parameters in the colonic crypts, and scintillation counts on mucosal scrapings were used for the estimation of mucosal deoxyribonucleic acid synthetic activity. Refeeding increased the labeling index (p less than 0.01), mitotic index (p less than 0.01), and mucosal deoxyribonucleic acid synthesis activity (p less than 0.01) in the proximal colon as well as in the defunctioned distal segment. Despite suppression of the postprandial rise in serum gastrin (p less than 0.01), antrectomy did not abolish the proliferative reaction in any colonic segment. These data confirm the existence of a potent stimulant of colonic cell proliferation that is released systematically after feeding. They indicate that gastrin is not the responsible stimulant and that another, yet unknown, physiological factor is involved.

Animals↗