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Biomedical subjects

H Levard

Publications and source records attributed to H Levard.

43 records · Page 3Linked to original sources
PubMedDate not supplied

Coelioscopic cholecystectomy: experience with 2006 cases.

2006 laparoscopic cholecystectomies (LC) were performed from April 1988 to December 1992 by three senior surgeons using the French technique and selective intraoperative cholangiography (IOC). Obesity was present in 318 patients (15.8%), respiratory insufficiency in 75 (3.7%), inflammation in 251 (12.5%), and common bile duct (CBD) stones in 83 (4.1%). The presence of these additional ailments is a good indication for LC. Conversion to laparotomy occurred in 43 cases (2.1%). The rate of complications was 2%; 25 (1.25%) were nonbiliary complications and 15 (0.7%) were biliary-related; there was one death. IOC is not effective in preventing biliary complications, as those observed in this study would not have been recognized or avoided by it. IOC is carried out only selectively to locate unsuspected stones in patients with risk factors of CBD lithiasis. Laparoscopic treatment of CBD stones is still controversial.

Adolescent↗
PubMedDate not supplied

[Gastric schwannoma. A case diagnosed by puncture biopsy].

One case of schwannoma of the stomach diagnosed with ultrasound-guided biopsy puncture is reported. This diagnosis is usually not established with radiographic and endoscopic examinations. A preoperative diagnosis allows partly predicting the type of exeresis to be performed. On the other hand, guided biopsy puncture seldom allows establishing a prognosis, for which the criteria are based on the analysis of the whole tumor and the possible discovery of synchronous or metachronous metastases.

Biopsy, Needle↗
PubMedDate not supplied

[Pilonidal sinus in a patient with Buckley's syndrome. A case report].

Buckley's syndrome is a nosologic entity characterized by the presence from birth of extremely elevated levels of circulating immunoglobulin E and an important deficiency of polymorphonuclear chemotaxis. The consequences of such alterations are represented by the premature rising of recurrent cutaneous, pulmonary and articular infections, slowing down of growth and quite significant disturbances of the immune system. We report a case which presents all the characteristics of Buckley's syndrome: familial history for atopy; otorhinolaryngologic, gynecologic and pulmonary recurrent infections from birth (caused by Staphylococcus, Candida albicans but also Proteus, Enterococcus, Pyocyanea and Moraxella) some of which necessitate surgery therapy; immune disturbances. The patient had hospitalized in our Surgery Department for sinus pilonidalis abscess. At a first treatment of removal of the primary orifice and accurate curettage of the cavity (Marti's intervention) there followed another operation of larger exeresis for an abscess relapse of the sinus at a distance of 2 months. In the interval between the two treatments, an eczematous patch of 8 cm diameter appeared on the left buttock, a probable manifestation of the state of hypersensitivity of the patient. We believe, therefore, that in patients with Buckley's syndrome who must be subjected to surgical intervention it is necessary to resort to a radical treatment from the beginning, given the particular tendency to an infection relapse presented in these cases.

Adult↗
PubMedDate not supplied

[Celioscopic appendectomy. Survey of the French Association of Surgery].

When first described in 1983 by Semm, coelioscopic appendectomy had little impact on the surgical community. However, since 1988, the growing widespread use coeliosurgery has lead to renewed interest in the technique. A survey was conducted among the members of the French Association of Surgery. There were 303 responses from 2,437 questionnaires: 195 concerned coelioscopic appendectomy and included a total of 11,086 cases. Most (55.9%) of the surgeons worked in private hospitals and had already gained experience with coelioscopy for gynaecological indications (56.4%). Programmed coelioscopic appendectomies had been performed by 68.3% and peritonitis was the indication in 48.2%. The meso-appendix was treated with coagulation and/or a clip. Peroperative complications were observed in 132 cases (1.19%). Conversion to laparotomy was necessary in 258 cases (2.33%). No deaths were reported. Postoperative complications were reported in 175 cases (1.58%). There were a total of 106 reoperations (0.95%); 43 times by repeat coelioscopy, 59 times by laparotomy and 4 times by Douglas puncture. Discharge was accorded 3.2 (mean) days after the operation. Coelioscopic appendectomy gives results comparable to the laparotomy technique. Its specific advantages are now being assessed in prospective studies.

Appendectomy↗
PubMedDate not supplied

Laparoscopic appendectomy. A study of 154 consecutive cases.

The recent development of mini-invasive surgery includes appendectomy. We report our results of 4 years experience in this type of approach. We have operated on 154 patients (61 men, 93 women), mean age 26.7 years, presenting with clinical signs of appendicitis. The operation was completely carried out by laparoscopy in 144 cases, including treatment of abscess in 13 and peritonitis in 8 cases. Operation was converted into laparotomy in 10 cases, 4 of which because of some difficulty in appendix dissection. No deaths were recorded. Eight (5.2%) post-operative complications occurred: 4 infections of the trocar hole, one of which the cause of readmission; 3 cases of pain and fever (in one a re-laparoscopy was performed because of suspicion of leakage of the appendicular stump); 1 residual hematoma requiring second laparoscopy. Mean duration of hospitalisation was 4.9 days (range 2-25 days): at present, mean hospitalisation is 2 and 6 days respectively in cases with and without peritonitis. In conclusion, laparoscopic appendectomy appears to be feasible in the majority of cases, with better results when the appendix is ectopic and/or in the presence of peritoneal reaction.

Acute Disease↗
PubMedDate not supplied

[A case of a left-sided gallbladder treated surgically via laparoscopy].

The authors relate about a case of symptomatic cholelithiasis, in which the organ was located in the inferior face of III hepatic segment and the surgical treatment was performed by laparoscopy. They discuss about etiopathogenesis of this anomaly, symptomatology referred by the patients and diagnostic procedures. Finally, they stress the necessity, in this case, to perform the cholecystectomy by anterograde approach in order to well visualize the anatomic structures and be safe to avoid injury of hepatic pedicle.

Adult↗