Search PubMed⌕ Search

Biomedical subjects

P Boutelier

Publications and source records attributed to P Boutelier.

At least 19 recordsLinked to original sources
PubMed1991

[Severe upper gastrointestinal hemorrhages due to peptic ulcer. A plea for admission to a surgical unit].

Despite improvements in exploratory methods and the introduction of endoscopic haemostasis procedures, bleeding remains a severe complication of peptic ulcers. A retrospective study of 142 cases collected over a 10-year period showed an overall mortality rate of 12.76 percent: 9.2 percent in non surgical patients and 17.1 percent in patients operated upon. The latter figure fell to 9 percent when cirrhotic patients were excluded. The criteria required for surgical treatment and the choice of the most appropriate operative technique are defined. In elderly people and/or in patients with underlying diseases, when the blood pressure is kept stable the risk of surgery is lower than the risk of cardiovascular collapse. This type of surgery is justified only if it eliminates all risk of recurrent bleeding.

Adolescent↗
PubMed1991

[Evaluation of the efficacy of a new generation of hemostatic collagen compresses. Results of a multicenter prospective study in visceral surgery and neurosurgery].

The hemostatic potential, tolerance and handiness of a new generation of hemostatic sheets (Hemostagene) were compared with those of reference collagen sheets in a randomized parallel-group multicenter study. Both types of hemostatic sheets, issued from calf derm, have been evaluated in digestive and neurosurgical pathologies. The comparability of both groups (52 patients in the Hemostagene group A, 54 in the reference group B) has been verified on morphological data, coagulation records and hemostasis conditions. The time required to achieve hemostasis was slightly, yet not significantly, shorter in group A (3 min 27 sec) than with the reference sheet (4 min 10 sec). This new sheet was judged significantly handier than the reference sheet. Adherence to the gloves and instruments was very significantly (p less than 0.0001) more frequent in the reference group B than in the group A. Both collagen sheets have quite similar clinical, biological and immunological tolerances which confirms the literature data. So, this new sheet, together with an hemostasis at least as good as the one obtained with the reference sheet, brings a highly improved handiness.

Bandages↗
PubMed1990

[A new method of surgical treatment of gastro-esophageal reflux. Retro-esophageal fundoplication associated with peritoneal tying of the cardia].

The technique proposed consists in tying the cardia with a strip of pre-esophageal peritoneum, along with performing a retro-esophageal fundoplication in proportion to the degree of hypotonia of the lower esophageal sphincter. The physiopathological bases of strip tying are described. A prospective study on 8 consecutive operated patients states the clinical, radiological and manometric results achieved.

Adult↗
PubMed1986

[Endoscopic sclerosis of esophageal varices].

The increasing popularity of treatment of esophageal varices by endoscopic sclerosis is the result of two factors. First, the principle underlying the procedure, which tends towards selective occlusion of the submucous venous network at the esophagogastric junction, where the risk of rupture is maximal, while respecting other periesophageal bypass pathways of portal blood. Second, the improvement of the apparatus used, thus simplifying the operation and reducing risks, and the improved definition of the limitations of medicosurgical treatment of portal hypertension. Results may be altered by several variables: protocol of injections, particularly intra- or paravascular site of injection, nature of sclerosing agent, type of endoscopy performed, size of varices, etiology of portal hypertension and severity of hepatic lesion and especially the relation between time of operation and the hemorrhagic episode. Hemostasis of a ruptured esophageal varix was obtained in 75 to 100% of cases. Adequate follow up and repeat injections are essential for varicose recurrences (long-term relapse rate = 50%) to avoid hemorrhagic complications.

Emergencies↗
PubMed1986

[Surgery of duodenal ulcer. In decline?].

The authors report their experience of the surgical treatment of duodenal ulcer disease and its complications over a 10 year period (1976-1986), i.e. 336 cases from a group of 10748 digestive tract endoscopies performed and 1126 duodenal ulcers identified (10.4%). The efficacy of new types of medical treatment (anti-secretory drugs, endoscopic hemostasis techniques, prostaglandins) and the improved follow-up of patients tend, despite the value and proven safety of Parietal-cell Vagotomy (elective procedure in 76% of the group), to modify: the epidemiological aspect of the disease in the sense of a decrease in the rate of ulcers with complications related to stenosis and perforation; the therapeutic aspect with more limited surgical indications. Is this the end of surgery for duodenal ulcer and its complications?

Duodenal Ulcer↗
PubMed1982

[Surgical treatment of acute complicated colitis. Report on twenty-eight cases (author's transl)].

Experience with 28 patients with acute diffuse complicated colitis operated on in emergency or semi emergency by the same surgical team is reviewed. The forms with colonic dilatation are the most numerous but do not resume the serious complications which may occur in the course of non specific inflammatory diseases of the colon. The operative mortality in this series was 10,7% (3/28). Peritoneal sepsis was the most significant factor contributing to mortality. It appears that the keystone to successful management is to prevent colonic perforation. Protracted medical management may be at last partly responsible for this complication. Failure of intensive medical therapy to induce rapid improvement constitutes an indication for definitive surgical treatment.

Acute Disease↗
PubMed1979

Observations during treatment of acute necrotizing pancreatitis with surgical ablation.

Seven patients with acute necrotizing pancreatitis were treated by surgical ablation. Immediate improvement was seen in six patients. Two patients died during the course of postoperative complications requiring reoperations. At operation, strikingly conforming lesions were found in the shape of a sharply limited necrotic portion of the gland. The body and tail of the pancreas constituted this necrotic portion in all patients. In a certain group of patients, the vascular anatomy infers a total infarction of the body and tail of the pancreas if a thrombosis of the transverse pancreatic artery occurs. In view of these observations, more interest should be directed toward the possibility of a vascular occlusion as a cause of pancreatic necrosis.

Acute Disease↗