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Biomedical subjects

J M Canard

Publications and source records attributed to J M Canard.

26 records · Page 2Linked to original sources
PubMed1986

[Instrumental dilation and transparieto-hepatic cholangioscopy for stenosis of a choledocho-duodenal anastomosis with gallstone formation].

A 94-year old woman presented with gallstone formation above a stenotic choledoco-duodenal anastomosis, responsible for episodes of cholangitis. After percutaneous biliary tract drainage, the anastomosis was dilated with an angioplasty catheter. As several stones persisted despite washing out, percutaneous cholangioscopy was performed. To introduce a small fibroscope into the biliary canals, transhepatic dilation up to 28 F was necessary. The last stones were pushed into the duodenum with the endoscope. Freedom of the biliary tract and patency of the anastomosis were ascertained.

Aged↗
PubMed1986

[Treatment of jaundice caused by neoplastic obstruction of the bile ducts with percutaneous placement of endoprostheses: 53 cases].

From October 1983 to October 1985, 53 patients with malignant biliary obstruction were referred to our institution for a transhepatic biliary stent. One or two endoprostheses were inserted in 46 patients (87 p. 100). Stent insertion was usually performed in two sessions, after two or three days of external drainage. There were 23 men and 23 women. Their mean age was 70.6 years +/- 12 years (m +/- DS). Fourty-two patients (91 p. 100) were referred after failure of an endoscopic or surgical drainage procedure; fourty-four p. 100 of the patients had stage II or III high periportal obstruction. Five cases of severe early complications (11 p. 100) and 8 delayed complications requiring in-hospital treatment (17 p. 100) were observed. Among the latter, 7 were due to plugging of the endoprosthesis. All patients were unfit for surgery either because at a high operative risk or because of the extent of the cancer. Our results showed that percutaneous biliary drainage can be achieved in a high percentage of cases following failure of a surgical or endoscopic drainage procedure. The endoscopic transpapillary approach, which allows the insertion of 12 French endoprostheses in one session should be tried first. Percutaneous biliary drainage should be performed as a complementary procedure when endoscopic drainage has failed or in stage II or III high periportal obstruction associated with persistent jaundice or cholangitis.

Adult↗
PubMed1986

[Pancreas divisum: clinical and therapeutic study in man. Apropos of 87 cases].

In order to evaluate the responsibility of pancreas divisum in the occurrence of pancreatitis, we studied retrospectively 1,808 endoscopic retrograde pancreatograms. Eighty-seven pancreas divisum (4.8 p. 100) were found in 50 males and 37 females, mean age 53.3 +/- 16.8 yrs. Acute pancreatitis was significantly more frequent (p less than 0.001) in this group (19.6 p. 100) than in the patients with fused pancreas (4.3 p. 100). The difference was also significant (p less than 0.01) for idiopathic recurrent acute pancreatitis. Histologic lesions in the dorsal pancreas were in favor of a retentional mechanism of pancreatitis. Sphincterotomy of the accessory papilla, proposed to improve the drainage of the dorsal pancreas, was performed in 11 patients (10 endoscopic, 1 surgical). This treatment, repeated in case of secondary stenosis of the accessory papilla, was successful in 5 out of 8 patients with acute pancreatitis followed up from 12 to 30 months. After reviewing the literature, secondary stenosis of accessory papilla was found significantly less frequently (p less than 0.05) after surgical sphincterotomy or sphincteroplasty (4 out of 46, 8.6 p. 100) than after endoscopic sphincterotomy (6 out of 22, 27.2 p. 100). Treatment, preferentially surgical, should be proposed only to patients with idiopathic recurrent pancreatitis before constitution of chronic non reversible pancreatitis.

Acute Disease↗
PubMed1982

[Oesophagitis during mechanical ventilation].

Twenty-one patients whose condition required mechanical ventilation with nasogastric intubation were investigated for oesophagitis before the 3rd day and on the 15th day of treatment, including endoscopy and biopsy. Lesions of oesophagitis were detected in 14 cases during the initial examination and in 19 cases on the second endoscopy. The course of the lesions varied from one patient to another and appeared to be unrelated to the course of the primary disease. Oesophagitis in these patients is probably due to frequent episodes of gastro-oesophageal reflux encouraged by cough, impaired consciousness and the presence of a tube. Reflux may also be the cause of inapparent and recurrent lung aspiration.

Adult↗