1
|
Bouras AF, Ioos E, Aoudia A, Kaci H, Benaibouche D, Merad-Boudia F. The vision and role of geriatric oncology in surgical treatment of the elderly patient. J Visc Surg 2018; 156:37-44. [PMID: 30416005 DOI: 10.1016/j.jviscsurg.2018.10.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The phenomenon of population aging is constantly on the rise, as are the medical needs of elderly subjects. Oncological treatment concerns an ever larger number of elderly patients, raising a number of not only practical and medical questions, but also the ethical interrogations associated with therapeutic decision-making, quality of life and therapeutic obstinacy (futile medical care). Surgeons are increasingly preoccupied by elderly patients on account of the cancer rate among them, and they are compelled to cope with challenges such as morbimortality and prolonged hospitalization. Geriatric oncology is a discipline of increasing importance of which the goal consists in comprehensive care of the elderly cancer patient, care taking into full account his physical and psychological aging, his somatic and cognitive comorbidities, and, last but least, his life expectancy. The opinions and recommendations of geriatric oncologists provide increasingly more orientation for the oncological therapeutic decision-making processes. The objective of this attempt at clarification is to discuss the contributions of this discipline to everyday surgical activity, to provide surgeons with some tools facilitating initial evaluation of their patients, and to remind the reader of situations in which oncological assistance is of paramount importance.
Collapse
Affiliation(s)
- A F Bouras
- Faculté de médecine d'Alger, Université Benyoucef Benkhedda, Alger 1, Algeria; Chirurgie générale et digestive, CHU Lamine Debaghine, boulevard Saïd Touati, Bab El Oued, Alger, 16000, Algeria.
| | - E Ioos
- Médecine polyvalente et gériatrie, centre hospitalier Germon-et-Gauthier, 62408 Béthune, France
| | - A Aoudia
- Clinique de psychiatrie, hôpital Fontan II, CHRU Lille, 59000 Lille, France
| | - H Kaci
- Faculté de médecine d'Alger, Université Benyoucef Benkhedda, Alger 1, Algeria; Chirurgie générale et digestive, CHU Lamine Debaghine, boulevard Saïd Touati, Bab El Oued, Alger, 16000, Algeria
| | - D Benaibouche
- Faculté de médecine d'Alger, Université Benyoucef Benkhedda, Alger 1, Algeria; Chirurgie générale et digestive, CHU Lamine Debaghine, boulevard Saïd Touati, Bab El Oued, Alger, 16000, Algeria
| | - F Merad-Boudia
- Faculté de médecine d'Alger, Université Benyoucef Benkhedda, Alger 1, Algeria; Chirurgie générale et digestive, CHU Lamine Debaghine, boulevard Saïd Touati, Bab El Oued, Alger, 16000, Algeria
| |
Collapse
|
2
|
Bouras AF, Bettahar N, Toumi H, Kazitani N, Kara L, Benmansour M. Living-Donor Kidney Transplantation in Developing Countries: Walking Sometimes the Tightrope Without a Net…. Sci Eng Ethics 2018; 24:1377-1378. [PMID: 28653165 DOI: 10.1007/s11948-017-9930-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2017] [Accepted: 06/07/2017] [Indexed: 06/07/2023]
Affiliation(s)
- Ahmed Fouad Bouras
- Kidney Transplantation Unit, Tidjani Damerdji University Medical Center, 13000, Tlemcen, Algeria.
- Chirurgie Générale Et Digestive, Centre Hospitalier Germon et Gauthier, BP 10809 Rue Delbecque, 62408, Béthune Cedex, France.
| | - Noureddine Bettahar
- Department of Anesthesiology, Tidjani Damerdji University Medical Center, 13000, Tlemcen, Algeria
| | - Hadjar Toumi
- Department of Nephrology, Tidjani Damerdji University Medical Center, 13000, Tlemcen, Algeria
| | - Nassim Kazitani
- Kidney Transplantation Unit, Tidjani Damerdji University Medical Center, 13000, Tlemcen, Algeria
| | - Lamia Kara
- Department of Nephrology, Tidjani Damerdji University Medical Center, 13000, Tlemcen, Algeria
| | - Mustapha Benmansour
- Department of Nephrology, Tidjani Damerdji University Medical Center, 13000, Tlemcen, Algeria
| |
Collapse
|
3
|
Doumenc B, Boutros M, Dégremont R, Bouras AF. Biliary leakage from gallbladder bed after cholecystectomy: Luschka duct or hepaticocholecystic duct? Morphologie 2016; 100:36-40. [PMID: 26404734 DOI: 10.1016/j.morpho.2015.08.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2014] [Revised: 08/04/2015] [Accepted: 08/20/2015] [Indexed: 06/05/2023]
Abstract
Anatomic variations in the biliary tract are common and can cause difficulties when a cholecystectomy is performed. One of the most common ones are hepaticocholecystic ducts and Luschka ducts, connecting the gallbladder or its bed to the bile ducts but distinction between these two types of ducts can be difficult. We do discuss here the differences between these anatomical variations, their origin and their clinical implications. These aberrant ducts may go unnoticed and may require further complementary procedures in case of postoperative biliary leakage. In addition to a careful surgical procedure and an examination of the cystic bed in the end of the intervention, an intraoperative cholangiography should be performed as often as possible.
Collapse
Affiliation(s)
- B Doumenc
- Chirurgie générale et digestive, service de chirurgie générale et digestive, centre hospitalier Germon-et-Gauthier, rue Delbecque, BP 10809, 62408 Béthune cedex, France
| | - M Boutros
- Chirurgie générale et digestive, service de chirurgie générale et digestive, centre hospitalier Germon-et-Gauthier, rue Delbecque, BP 10809, 62408 Béthune cedex, France
| | - R Dégremont
- Chirurgie générale et digestive, service de chirurgie générale et digestive, centre hospitalier Germon-et-Gauthier, rue Delbecque, BP 10809, 62408 Béthune cedex, France
| | - A F Bouras
- Chirurgie générale et digestive, service de chirurgie générale et digestive, centre hospitalier Germon-et-Gauthier, rue Delbecque, BP 10809, 62408 Béthune cedex, France.
| |
Collapse
|
4
|
Bouras AF, Marin H, Bouzid C, Pruvot FR, Zerbib P, Truant S. Pancreas-preserving management in reinterventions for severe pancreatic fistula after pancreatoduodenectomy: a systematic review. Langenbecks Arch Surg 2015; 401:141-9. [DOI: 10.1007/s00423-015-1357-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Accepted: 11/05/2015] [Indexed: 12/31/2022]
|
5
|
Bouras AF, Genty C, Guilbert V, Dadda M. Organ Procurement and Social Networks: The End of Confidentiality? Sci Eng Ethics 2015; 21:837-838. [PMID: 25096060 DOI: 10.1007/s11948-014-9577-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2014] [Accepted: 07/30/2014] [Indexed: 06/03/2023]
Affiliation(s)
- Ahmed Fouad Bouras
- Service de Chirurgie Générale et Digestive, Centre Hospitalier Germon-et-Gauthier, rue Delbecque, BP 10809, 62408, Béthune Cedex, France,
| | | | | | | |
Collapse
|
6
|
Deshorgue AC, Bouras AF, Riva F, Boleslawski E, Pruvot FR, Truant S. Hepatocellular carcinoma in situs ambiguus: CT findings of a rare disposition. Surg Radiol Anat 2014; 37:419-24. [PMID: 24916356 DOI: 10.1007/s00276-014-1322-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2014] [Accepted: 06/02/2014] [Indexed: 11/28/2022]
Abstract
Heterotaxic disorders or situs ambiguus are uncommon anatomical variations constituted by a partial mirror-image disposition of intra thoracic and/or abdominal solid organs. These variations are challenging because rarely met in a surgeon's career, and because of the coexistence of numerous other anatomical variants, like ones related to the asymmetrical organs, causing difficulties when a surgical management is required. We report the case of a 57-year-old patient presenting liver cirrhosis in which regular follow-up discovered a hepatocellular carcinoma of the right part of the liver associated to numerous anatomical variations in the setting of a situs ambiguus. This patient was successfully treated by a sub-segmentectomy via a right sub-costal laparotomy. There were neither peroperative nor postoperative complications. This case emphasizes the technical difficulties faced, successfully managed thanks to a good preoperative screening, and allows us to review literature of such a rare and challenging situation.
Collapse
Affiliation(s)
- Anne-Claire Deshorgue
- Service de Chirurgie Digestive et Transplantations, Hopital Claude Huriez, CHU, Univ Nord de France, 59000, Lille, France
| | | | | | | | | | | |
Collapse
|
7
|
Bouras AF, Vincentelli A, Boleslawski E, Truant S, Liddo G, Prat A, Pruvot FR, Zerbib P. Liver endometriosis presenting as a liver mass associated with high blood levels of tumoral biomarkers. Clin Res Hepatol Gastroenterol 2013; 37:e85-8. [PMID: 23562788 DOI: 10.1016/j.clinre.2013.02.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2013] [Revised: 02/07/2013] [Accepted: 02/19/2013] [Indexed: 02/04/2023]
Abstract
Endometriosis is a dissemination of endometrial-like tissue outside the uterine cavity, responsible for pain and impaired fertility in women of childbearing age. Although endometriosis generally occurs in the pelvis, it can be located further away. We describe the case of a 35-year-old woman who was admitted for further evaluation of a cystic mass of the liver that had invaded the right ventricle and caused pain. Serum levels of the tumor markers CA 125, CA 15-3 and CA 19-9 were elevated. The tumor was resected with a small part of the right ventricle free wall, the diaphragm and the left liver lobe. A histological analysis confirmed that the mass was a benign endometrial cyst. The postoperative course was uneventful and the patient remains asymptomatic with 5 year follow-up. A diagnosis of endometriosis should be considered for thoraco-abdominal cystic masses associated with menses-related pain in women of childbearing age.
Collapse
Affiliation(s)
- Ahmed Fouad Bouras
- Service de chirurgie digestive et transplantations, hôpital Claude-Huriez, CHU, université Nord-de-France, 59000 Lille, France.
| | | | | | | | | | | | | | | |
Collapse
|
8
|
Affiliation(s)
- H Marin
- Chirurgie digestive et transplantations, hôpital Claude-Huriez, université Nord-de-France, CHU de Lille, 59000 Lille, France
| | | | | | | | | | | | | |
Collapse
|
9
|
Boleslawski E, Bouras AF, Truant S, Liddo G, Herrero A, Badic B, Audet M, Altieri M, Laurent A, Declerck N, Navarro F, Létoublon C, Wolf P, Chiche L, Cherqui D, Pruvot FR. Hepatic artery ligation for arterial rupture following liver transplantation: a reasonable option. Am J Transplant 2013; 13:1055-1062. [PMID: 23398886 DOI: 10.1111/ajt.12135] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2012] [Revised: 11/21/2012] [Accepted: 12/07/2012] [Indexed: 01/25/2023]
Abstract
Hepatic artery (HA) rupture after liver transplantation is a rare complication with high mortality. This study aimed to review the different managements of HA rupture and their results. From 1997 to 2007, data from six transplant centers were reviewed. Of 2649 recipients, 17 (0.64%) presented with HA rupture 29 days (2-92) after transplantation. Initial management was HA ligation in 10 patients, reanastomosis in three, aorto-hepatic grafting in two and percutaneous arterial embolization in one. One patient died before any treatment could be initiated. Concomitant biliary leak was present in seven patients and could be subsequently treated by percutaneous and/or endoscopic approaches in four patients. Early mortality was not observed in patients with HA ligation and occurred in 83% of patients receiving any other treatment. After a median follow-up of 70 months, 10 patients died (4 after retransplantation), and 7 patients were alive without retransplantation (including 6 with HA ligation). HA ligation was associated with better 3-year survival (80% vs. 14%; p=0.002). Despite its potential consequences on the biliary tract, HA ligation should be considered as a reasonable option in the initial management for HA rupture after liver transplantation. Unexpectedly, retransplantation was not always necessary after HA ligation in this series.
Collapse
Affiliation(s)
- E Boleslawski
- UMR 8161, CNRS, Institut Biologique de Lille, France.,Service de Chirurgie Digestive et Transplantations, Hôpital Huriez, CHU, Univ Nord-de-France, F-59000, Lille, France
| | - A F Bouras
- Service de Chirurgie Digestive et Transplantations, Hôpital Huriez, CHU, Univ Nord-de-France, F-59000, Lille, France
| | - S Truant
- Service de Chirurgie Digestive et Transplantations, Hôpital Huriez, CHU, Univ Nord-de-France, F-59000, Lille, France
| | - G Liddo
- Service de Chirurgie Digestive et Transplantations, Hôpital Huriez, CHU, Univ Nord-de-France, F-59000, Lille, France
| | - A Herrero
- Service de Chirurgie Digestive, Hôpital St-Eloi, Montpellier, France
| | - B Badic
- Département de Chirurgie Digestive et de l'Urgence, CHU, Grenoble, France
| | - M Audet
- Service de Chirurgie Digestive et Transplantation, Hôpitaux Universitaires de Strasbourg, France
| | - M Altieri
- Service de Chirurgie Digestive, CHU Côte de Nacre, Caen, France
| | - A Laurent
- Service de Chirurgie Digestive, Hôpital Henri-Mondor, APHP, Paris, France
| | - N Declerck
- Service de Chirurgie Digestive et Transplantations, Hôpital Huriez, CHU, Univ Nord-de-France, F-59000, Lille, France
| | - F Navarro
- Service de Chirurgie Digestive, Hôpital St-Eloi, Montpellier, France
| | - C Létoublon
- Département de Chirurgie Digestive et de l'Urgence, CHU, Grenoble, France
| | - P Wolf
- Service de Chirurgie Digestive et Transplantation, Hôpitaux Universitaires de Strasbourg, France
| | - L Chiche
- Service de Chirurgie Digestive, CHU Côte de Nacre, Caen, France
| | - D Cherqui
- Service de Chirurgie Digestive, Hôpital Henri-Mondor, APHP, Paris, France
| | - F R Pruvot
- UMR 8161, CNRS, Institut Biologique de Lille, France
| |
Collapse
|
10
|
Bouras AF, Truant S, Beregi JP, Sergent G, Delemazure O, Liddo G, Lebuffe G, Zerbib P, Pruvot FR, Boleslawski E. Atrial embolism caused by portal vein embolization: Treatment by percutaneous withdrawal and stenting. World J Hepatol 2012; 4:412-4. [PMID: 23355922 PMCID: PMC3554808 DOI: 10.4254/wjh.v4.i12.412] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2011] [Revised: 11/04/2011] [Accepted: 11/14/2012] [Indexed: 02/06/2023] Open
Abstract
Hepatectomy remains the only curative treatment for many primary and secondary liver cancers. Portal vein embolization (PVE) has been used to increase the volume of the future liver remnant and thus lower the risk of small-for-size syndrome and postoperative liver failure. This technique has proven its safety, with a low post-procedure morbidity rate. Here, we describe a very rare case in which a young patient suffered a glue embolism to the right atrial cavity following PVE in preparation for a major hepatectomy for colorectal metastasis. The foreign body was withdrawn from the heart with a femoral, percutaneous device and trapped against the wall of the femoral vein with a self-expanding metal stent. Our report shows that this previously unknown complication of PVE can be resolved without recourse to sternotomy and open heart surgery.
Collapse
Affiliation(s)
- Ahmed Fouad Bouras
- Ahmed Fouad Bouras, Stéphanie Truant, Guido Liddo, Philippe Zerbib, François-René Pruvot, Emmanuel Boleslawski, Service de Chirurgie Digestive et Transplantation, CHU, Univ Nord de France, F-59000 Lille, France
| | | | | | | | | | | | | | | | | | | |
Collapse
|
11
|
Boleslawski E, Decanter G, Truant S, Bouras AF, Sulaberidze L, Oberlin O, Pruvot FR. Right hepatectomy with extra-hepatic vascular division prior to transection: intention-to-treat analysis of a standardized policy. HPB (Oxford) 2012; 14:688-99. [PMID: 22954006 PMCID: PMC3461376 DOI: 10.1111/j.1477-2574.2012.00519.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Right hepatectomy (RH) is the most common type of major hepatectomy and can be achieved without portal triad clamping (PTC) in non-cirrhotic liver. The present study reviews our standardized policy of performing RH without systematic PTC. METHODS One hundred and eighty-one consecutive RH were performed in non-cirrhotic patients, with division of the right afferent and efferent blood vessels prior to transection, without systematically using PTC. Prospectively collected data were analysed, focusing on the following endpoints: need for salvage PTC, ischaemic time, blood loss and post-operative outcome. RESULTS Extra-hepatic division of the right hepatic vessels was feasible in all patients, but was ineffective in 48 patients (26.5%) who required salvage PTC during transection. In those patients, the median ischaemic time was 20 min. The median blood loss was 500 ml (50-3000). Six patients (3.3%) experienced post-operative liver failure. Overall morbidity, severe morbidity and mortality were 42%, 12.1% and 1.6%, respectively, with peri-operative transfusion rate (16.6%) being the only factor associated with morbidity. DISCUSSION By performing RH with extra-hepatic vascular division prior to transection, PTC can be safely avoided in the majority of patients.
Collapse
Affiliation(s)
- Emmanuel Boleslawski
- Service de Chirurgie Digestive et Transplantations, Hôpital Huriez, Rue Michel Polonovski, CHU, Univ Nord-de-France, Lille, France.
| | | | | | | | | | | | | |
Collapse
|
12
|
Bouras AF, Boleslawski E, Hervieux E, Truant S, Pruvot FR. Exposure for hepatic surgery in the obese patient: an innovative adaptation in time of need…. J Visc Surg 2012; 149:e262-3. [PMID: 22704710 DOI: 10.1016/j.jviscsurg.2012.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Obesity has become a major public health concern. More and more patients with substantial obesity require surgery including complex hepatobiliary interventions. The morphology of these patients can make surgery difficult, especially in terms of exposure. We report the case of an obese patient who required a left hemihepatectomy for colorectal liver metastasis. It was very difficult to obtain adequate exposure; this problem was solved by transcutaneous introduction of the handle of a broad costal margin retractor. We describe this maneuver, which allowed us to carry out the intervention under excellent conditions.
Collapse
Affiliation(s)
- A F Bouras
- Service de chirurgie digestive et transplantations, université Nord-de-France, hôpital Claude-Huriez, CHU de Lille, 59000 Lille, France.
| | | | | | | | | |
Collapse
|
13
|
Butet Y, Bouras AF, Truant S, Pruvot FR. Pseudoaneurysm of the cystic artery as a complication of laparoscopic cholecystectomy. Dig Liver Dis 2012; 44:449-50. [PMID: 22365670 DOI: 10.1016/j.dld.2011.11.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2011] [Revised: 10/25/2011] [Accepted: 11/27/2011] [Indexed: 12/11/2022]
|
14
|
Bouras AF, Truant S, Zerrweck C, Boleslawski E, Pruvot FR, Zerbib P. Image of the month. Cystic hepatocellular carcinoma. ACTA ACUST UNITED AC 2011; 146:755-6. [PMID: 21690455 DOI: 10.1001/archsurg.2011.124-a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Ahmed Fouad Bouras
- Department of Digestive Surgery and Transplantations, Aile Ouest, Hopital Huriez, Lille, France.
| | | | | | | | | | | |
Collapse
|
15
|
Zerbib P, Koriche D, Truant S, Bouras AF, Vernier-Massouille G, Seguy D, Pruvot FR, Cortot A, Colombel JF. Pre-operative management is associated with low rate of post-operative morbidity in penetrating Crohn's disease. Aliment Pharmacol Ther 2010; 32:459-65. [PMID: 20497144 DOI: 10.1111/j.1365-2036.2010.04369.x] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Ileocaecal resection for penetrating Crohn's disease is still challenging with a high rate of post-operative morbidity and faecal diversion. AIM To report retrospectively the results of pre-operative management for penetrating Crohn's disease focusing on the rate of post-operative major morbidities and need for faecal diversion. METHODS Between 1997 and 2007, 78 patients with penetrating Crohn's disease underwent a first ileocaecal resection after a pre-operative management consisting in bowel rest, nutritional therapy, intravenous antibiotics, weaning off steroids and immunosuppressors, and drainage of abscesses when appropriate. RESULTS Resection was performed for terminal ileitis associated with (n = 41), abscesses (n = 37) or both (n = 5). A pre-operative nutritional therapy was performed in 50 patients (68%) for 23 days (range, 7-69 days) along with a weaning off steroids and immunosuppressors. A diverting stoma was performed for six patients (7.7%). There was no post-operative death. Post-operative complications were classified as minor in 10 patients (12.8%), and major in four patients (5%). Overall, the post-operative course was uneventful in 58 patients (74%). CONCLUSION Pre-operative management for penetrating Crohn's disease allowed ileocaecal resection with low rates of post-operative morbidity and faecal diversion.
Collapse
Affiliation(s)
- P Zerbib
- Department of Digestive Surgery and Transplantation, Univ Lille Nord de France, CHU Lille, France.
| | | | | | | | | | | | | | | | | |
Collapse
|