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Biomedical subjects

M Barthet

Publications and source records attributed to M Barthet.

68 records · Page 4Linked to original sources
PubMed1993

Management of cysts and pseudocysts complicating chronic pancreatitis. A retrospective study of 143 patients.

One hundred and forty-three patients presenting with 170 cysts and pseudocysts complicating chronic pancreatitis were followed between 1980 and 1990. Thirteen patients were managed conservatively and pseudocysts spontaneously disappeared in 11 patients. Cysts were small (average 28 mm), often communicating with the ductal system without dilatation of the main pancreatic duct. Percutaneous puncture was performed in 47 patients with a low morbidity rate (5%) but a high rate of recurrence (57%). Thirteen of 39 patients (33%) who underwent percutaneous puncture as initial treatment did not require further therapy. Communication of pancreatic cysts with the ductal system was associated with poorer results after percutaneous puncture. Percutaneous drainage was performed in 9 patients with a low morbidity rate (12%). The mean duration of drainage was 10.4 days. Five patients were definitively cured. Seventy-eight endoscopic cystoenterostomies were performed in 71 patients. Complications occurred in 12 patients (15.3%) and one patient died (1.3%). Endoscopic cystoenterostomy was effective in 39 of 54 patients initially treated with this technique (72.2%). Sixty-three patients underwent surgical management, principally internal drainage (83%), with a morbidity rate of 13.2% and a mortality rate of 1.3%. Twenty-one of the 29 patients (72%) who underwent surgery as initial treatment did not require further therapy. Endoscopic cystoenterostomy is an efficient treatment of cysts and pseudocysts complicating CP when anatomical conditions are favorable. Percutaneous drainage also appears to be a satisfactory treatment modality. Surgery should be considered in cases of failure or technical impossibility of endoscopic or percutaneous approaches.

Chronic Disease↗
PubMed1992

[Treatment of pseudocysts in acute pancreatitis. Retrospective study of 45 patients].

A total of 55 pancreatic pseudocysts in 45 patients with acute pancreatitis were managed between 1980 and 1990. Six patients were managed conservatively with resolution of pseudocysts in 5 patients. All pancreatic pseudocysts that disappeared were smaller than 35 mm. CT or ultrasound-guided aspiration were performed in 26 patients with a morbidity rate of 5%. Nine among 21 patients (42%) who were initially treated by percutaneous puncture were definitively cured: all pseudocysts were smaller than 55 mm. Nine patients were managed by long-term percutaneous drainage: 3 minor complications occurred and in 7 patients, no other treatment was necessary even for large pseudocysts. Endoscopic cystoenterostomy was performed in 12 patients. Only 15 pseudocysts (27%) bulged into the digestive wall, mainly of the stomach. Three complications (following 2 cystogastrostomies) occurred and one patient died after endoscopic cystogastrostomy. In 7 patients (58%), no other treatment was necessary even for large pancreatic pseudocysts. Surgery was required in 13 patients but only 4 patients underwent surgery as primary treatment. One major complication occurred and one patient died. Percutaneous drainage and endoscopic cystoenterostomy when technically feasible, are effective treatments of pancreatic pseudocysts complicating acute pancreatitis.

Acute Disease↗
PubMed1991

Is tobacco a risk factor for chronic pancreatitis and alcoholic cirrhosis?

In a case control study alcohol intake and tobacco use were assessed between 1975 and 1987 in 103 male patients suffering from alcoholic cirrhosis of the liver, in 145 patients with chronic pancreatitis, and in 264 control subjects. The patients with chronic pancreatitis were significantly younger than the patients with cirrhosis (mean (SD) age 41.92 (2.4) v 60.9 (11.6) years). Among the patients with chronic pancreatitis, 94% were both smokers and drinkers compared with 83% of patients with cirrhosis of the liver. The relative risks for each disease were calculated by conditional multiple logistic regression. Whereas daily intake of alcohol was a major risk factor for both cirrhosis of the liver and chronic pancreatitis, smoking was significantly related only to the risk of having chronic pancreatitis. Moreover, the mean age at onset of pancreatitis was lower among smokers.

Adult↗
PubMed1989

[Vitamins A and E in digestive cancers].

Vitamins A and E, transthyretin (TT) and retinol binding protein (RBP) plasma levels were assayed in 70 patients having a recently diagnosed digestive cancer and in 116 controls. After adjustment for sex and age, vitamin A or RBP and TT were found lowered in digestive cancer but vitamin E was lowered only in esophagus cancer. The relationship of vitamin levels to the relative risk of digestive cancer was calculated by multiple logistic conditional regression. TT level remained the only significant parameter. Since TT levels are strongly influenced by the nutritional status of patients, our results suggest that the decreased blood levels of vitamin A and its carriers observed in digestive cancer are the consequence of nutritional alterations evoked by the disease.

Adult↗
PubMedDate not supplied

[Two stage videoassisted restorative proctocolectomy. Early experience of 12 cases].

AIM OF THE STUDY: This study reports our early experience in two-stage video assisted restorative proctocolectomy (RPC). PATIENTS AND METHODS: From May 1999 to May 2003, 12 video assisted RPCs were performed (mucosal ulcerative colitis: n = 11; familial adenomatous polyposis: n = 1). These patients were matched for age, gender, body mass index and indication for surgery, with 12 patients who underwent RPC by laparotomy (open group). RESULTS: Median operative time was significantly longer in the video assisted RPC group (400 min; range: 360-490) vs open group (300 min; range: 210-390) (P = 0.003). A conversion in midline laparotomy (under the umbilicus) was necessary in 3/12 patients (25%) in the video assisted RPC group. Return to bowel function and oral intake occurred two days earlier after video assisted RPC (respectively, P = 0.009 and P = 0.0001) but length of stay was not significantly shorter in this group. A complication occurred in 3/12 patients (25%) in both groups, which lead to a reoperation in one patient in the open group (ns). CONCLUSION: Two-stage videoassisted RPC is feasible at the cost of a lengthening of operative time, Nevertheless postoperative results after video assisted RPC are comparable to those obtained after RPC by laparotomy.

Adenomatous Polyposis Coli↗