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Tarrerias AL, Costil V, Vicari F, Létard JC, Adenis-Lamarre P, Aisène A, Batistelli D, Bonnaud G, Carpentier S, Dalbiès P, Ecuer S, Etienne J, Fantoli M, Grunberg B, Lannoy P, Lapuelle J, Margulies A, Neumeier M, Rouillon JM, Schmets L, Pingannaud MP, Coulom P, Kholer F, Canard JM. The effect of inactivated Lactobacillus LB fermented culture medium on symptom severity: observational investigation in 297 patients with diarrhea-predominant irritable bowel syndrome. Dig Dis 2011; 29:588-91. [PMID: 22179215 DOI: 10.1159/000332987] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [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: 02/02/2023]
Abstract
INTRODUCTION Little is known about the intensity of symptoms of diarrhea-predominant IBS (IBS-D) or the consequences of the disease on patients' health-related quality of life (HRQOL). This observational investigation assessed the symptoms (abdominal pain, bloating, number of stools per day, and stool consistency), impact on HRQOL, and consequence on anal continence in 297 patients with IBS-D before and after 1 month of probiotic treatment with Lacteol (inactivated Lactobacillus LB plus fermented culture medium). METHODS Functional assessment using a standardized visual analogue scale in order to quantify abdominal pain, bloating, and quality of life before and after 1 month of treatment with 2 capsules/day of Lacteol. The number of symptomatic days per week, number of stools, consistency of stools, secondary fecal incontinence rate, and potential trigger effect of food were quantified. A χ2 test was used to compare qualitative data and the variance of quantitative criteria was analyzed. RESULTS The pain score decreased from 4.46±0.15 on a scale of 0-10 before treatment to 2.8±0.14 after treatment (p<0.0001). Bloating decreased from 4.49±0.18 to 2.5±0.15 on a scale of 0-10 (p<0.0001). The HRQOL score, which is inversely correlated with quality of life, decreased from 5.99±0.14 to 3.92±0.16 (p<0.0001). In this cohort study, the fecal incontinence rate secondary to diarrhea was clearly higher than that of the general population: 18% versus a prevalence of 9-10%, according to different studies. The mean number of stools per week decreased from 17.59 to 12.83 after treatment (p<0.0001). Before treatment, 54% of patients had watery stools and 46% had smooth stools; at the end of treatment, only 18.5% of patients still had watery stools, and 34% had normal stools. 52% of patients attributed their symptoms to their diet: 34% to vegetables, 29% to fruit, 15% to milk, 15% to fat, 6% to peppers and spices, and 4% to sugar. CONCLUSION This observational investigation shed new light on patients with IBS-D, the HRQOL of which is altered by a fecal incontinence rate twice as high as that of the general population. Correlation with diet is confirmed by 1 out of 2 patients reporting poor tolerance of fiber and dairy products. Nutritional management should thus be part of these patients' treatment. Inactivated Lactobacillus LB plus fermented culture medium is a probiotic drug that has been used by physicians for a long time to treat patients with diarrhea. Strongly concentrated, it has no side effects and seems to help these patients. Due to a strong placebo effect in patients with this pathology, however, a controlled study is necessary to confirm this result.
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Affiliation(s)
- A L Tarrerias
- Hôpital Foch, 40, rue Worth, FR–92151 Suresnes, France.
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Heresbach D, Kornhauser R, Seyrig JA, Coumaros D, Claviere C, Bury A, Cottereau J, Canard JM, Chaussade S, Baudet A, Casteur A, Duval O, Ponchon T. A national survey of endoscopic mucosal resection for superficial gastrointestinal neoplasia. Endoscopy 2010; 42:806-13. [PMID: 20821362 DOI: 10.1055/s-0030-1255715] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [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: 12/14/2022]
Abstract
BACKGROUND AND STUDY AIM Studies on endoscopic mucosal resection (EMR) are mostly based on data from centers with high expertise. We report the average EMR results in a national survey of consecutive patients in France. METHODS A 1-year survey was carried out to record immediate outcome data of all EMRs performed, regardless of lesion size or gastrointestinal location. RESULTS Overall, 1335 EMRs in 1210 patients were reported by 241 of the 736 gastroenterologists who performed such procedures (33 %). Resections were done for upper gastrointestinal lesions in 125 cases (41 esophageal, 43 gastric, and 41 duodenal lesions), in 45 % of cases using specific EMR techniques such as ligation, cap, or traction. The technique for resecting the 1210 lower gastrointestinal lesions mostly consisted of saline-assisted polypectomy or EMR, with specific techniques used in only 2.2 %. En bloc resection was less common with esophageal (46 %) or duodenal (54 %) neoplasms than in the lower gastrointestinal tract (73 %); size also had some influence (53 % > 1 cm vs. 92 % ≤ 1 cm). The overall complication rate was 5.2 %; the rate was lower for lesions 1 cm or smaller (0.6 % vs. 4.6 %). Fifty-four early and 17 delayed complications were recorded, in 12 % of upper gastrointestinal and 4.6 % of colonic lesions. Surgery became necessary in 1.6 % for upper and 2.9 % for lower gastrointestinal neoplasms. No association was seen between physician EMR caseload and either en bloc resection rate or complication rate. CONCLUSIONS EMR in general, especially saline-assisted polypectomy in the colon, appears to be reasonably safe even when performed by nonexperts. EMR for larger or for upper gastrointestinal lesions should probably be limited to high-volume centers.
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Affiliation(s)
- D Heresbach
- Observatoire de la Mucosectomie Endoscopique en Gastroenterologie (OMEGA), under the aegis of the Société Française d'Endoscopie Digestive (SFED), Paris, France.
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3
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Boyer J, Laugier R, Chemali M, Arpurt JP, Boustière C, Canard JM, Dalbies PA, Gay G, Escourrou J, Napoléon B, Palazzo L, Ponchon T, Richard-Mollard B, Sautereau D, Tucat G, Vedrenne B. French Society of Digestive Endoscopy SFED guideline: monitoring of patients with Barrett's esophagus. Endoscopy 2007; 39:840-2. [PMID: 17703397 DOI: 10.1055/s-2007-966653] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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Napoleon B, Ponchon T, Lefebvre RR, Heresbach D, Canard JM, Calazel Benque A, Boustiere C, Gay G, Laugier R. French Society of Digestive Endoscopy (SFED) Guidelines on performing a colonoscopy. Endoscopy 2006; 38:1152-5. [PMID: 17111341 DOI: 10.1055/s-2006-944790] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
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5
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Barthet M, Gay G, Sautereau D, Ponchon T, Napoleo B, Boyer J, Canard JM, Dalbies P, Escourrou J, Greff M, Lapuelle J, Letard JC, Marchetti B, Palazzo L, Rey JF. Endoscopic surveillance of chronic inflammatory bowel disease. Endoscopy 2005; 37:597-9. [PMID: 15933939 DOI: 10.1055/s-2005-861421] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
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6
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Beaugerie L, Napoleon B, Ponchon T, Boyer J, Canard JM, Dalbies P, Escourrou J, Greff M, Lapuelle J, Letard JC, Marchetti B, Palazzo L, Rey JF, Sautereau D. Guidelines of the French Society for Digestive Endoscopy (SFED). Role of endoscopy in microscopic colitis. Endoscopy 2005; 37:97-8. [PMID: 15657871 DOI: 10.1055/s-2004-826117] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
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7
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Barthet M, Napoleon B, Gay G, Ponchon T, Sautereau D, Arpurt JP, Boustiere C, Boyer J, Canard JM, Dalbies PA, Escourrou J, Greff M, Lapuelle J, Laugier R, Letard JC, Marchetti B, Palazzo L, Vedrenne B. Antibiotic prophylaxis for digestive endoscopy. Endoscopy 2004; 36:1123-5. [PMID: 15578308 DOI: 10.1055/s-2004-826118] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Affiliation(s)
- M Barthet
- Société Française d'Endoscopie Digestive (SFED)
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Rey JF, Dumas R, Canard JM, Ponchon T, Sautereau D, Helbert T, Escourrou J, Gay G, Giovannini M, Greff M, Grimaud JC, Lapuelle J, Marchetti B, Napoleon B, Palazzo L. Guidelines of the French Society of Digestive Endoscopy: biliary stenting. Endoscopy 2002; 34:169-73, 181-5. [PMID: 11822014 DOI: 10.1055/s-2002-19846] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- J F Rey
- French Society of Digestive Endoscopy, Saint Laurent du Var, France
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Canard JM, Gorce D, Napoléon B, Richard-Molard B, Caucanas JP, Dalbiès P, Revol C, Letard JC, Le Bourgeois P, Clanet J, Vandromme L, Greff M, Lugand JJ, Levy P, Lapuelle J. Fleet® phospho soda: pour une meilleure acceptabilité de la préparation colique avant coloscopie. Etude comparative randomisée menée en simple aveugle versus polyéthylène glycol. ACTA ACUST UNITED AC 2001. [DOI: 10.1007/bf03022144] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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10
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Affiliation(s)
- J M Canard
- Centre Médico-Chirurgical du Trocadéro, Paris, France
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11
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Affiliation(s)
- M Greff
- French Society of Digestive Endoscopy, Institut Arnault Tzanck, St. Laurent du Var.
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12
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Canard JM, Cellier C, Houcke P, Laurent J, Gorce D, Landi B. Prospective multicenter study comparing a standard reusable sphincterotome with a disposable triple-lumen sphincterotome. Gastrointest Endosc 2000; 51:704-7. [PMID: 10840304 DOI: 10.1067/mge.2000.105720] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [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: 12/10/2022]
Abstract
BACKGROUND Few data are available on the comparative performance of different types of sphincterotome. The aim of this study was to compare the efficacy of endoscopic sphincterotomy performed with either a reusable, single-lumen sphincterotome or a disposable triple-lumen instrument. METHODS Seventy-seven consecutive adults requiring endoscopic sphincterotomy were prospectively and randomly assigned treatment with either a standard reusable single-lumen sphincterotome (group A, n = 38) or a disposable triple-lumen sphincterotome with a guidewire (group B, n = 39). The success rate, complications, and cost of the procedure per patient were compared. RESULTS Deep cannulation was successful in 87% of cases in each group and sphincterotomy was achieved in 76% and 84% of cases in group A and B, respectively (NS). In the endoscopists' opinion the two instruments performed almost equally well. Twelve procedure-related complications occurred: 5 (all hemorrhages) in group A and 7 (1 hemorrhage, 4 cases of pancreatitis and 2 of cholangitis) in group B (NS). Eight reusable sphincterotomes were used with a cost of $61 per patient, compared with 39 disposable sphincterotomes with a cost of $241 per patient (p = 0.02). CONCLUSIONS A standard reusable sphincterotome is satisfactory for most endoscopic sphincterotomies, and yields a substantial cost savings without compromising the success or safety of the procedure.
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Affiliation(s)
- J M Canard
- Services d'Endoscopie Digestive, Paris, France
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13
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Systchenko R, Marchetti B, Canard JM, Palazzo L, Ponchon T, Rey JF, Sautereau D. [Recommendations for cleaning and disinfection procedures in digestive tract endoscopy. The French Society of Digestive Endoscopy]. Gastroenterol Clin Biol 2000; 24:520-9. [PMID: 10891739] [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] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Affiliation(s)
- R Systchenko
- Service d'Hépato-Gastroentérologie, Hôpital Dupuytren, CHU, Limoges
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Canard JM. [Which explorations are useful for colonic cancer diagnosis?]. Gastroenterol Clin Biol 1998; 22:S78-84. [PMID: 9762242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
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15
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Burtin P, Palazzo L, Canard JM, Person B, Oberti F, Boyer J. Diagnostic strategies for extrahepatic cholestasis of indefinite origin: endoscopic ultrasonography or retrograde cholangiography? Results of a prospective study. Endoscopy 1997; 29:349-55. [PMID: 9270914 DOI: 10.1055/s-2007-1004214] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.0] [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: 02/05/2023]
Abstract
BACKGROUND AND STUDY AIMS Due to its lower morbidity, it has been suggested that endoscopic ultrasonography (EUS) might replace endoscopic retrograde cholangiography (ERC) in the management of extrahepatic cholestasis of unknown origin. The present study aimed to compare the diagnostic accuracy of EUS and ERC in the management of cholestasis of unknown origin, taking into account the patient's general status and the necessity of endoscopic therapy. PATIENTS AND METHODS Sixty-eight patients with cholestasis of unknown origin were studied prospectively. EUS followed by ERC was carried out on a blinded basis by two endoscopists; diagnostic and therapeutic suggestions were made after either examination. During the ERC procedure and before withdrawing the tube, the endoscopist provided the final conclusions and carried out appropriate endoscopic treatment. RESULTS A correct diagnosis was obtained with EUS and ERC in 94% and in 92% of cases, respectively (not significant). After EUS, diagnostic ERC was necessary for diagnosis and therapy in 24% and 58% of cases, respectively. After ERC, EUS was requested in 41% of cases. The higher the American Society of Anesthesiologists (ASA) grade, the less it was necessary to perform a complementary investigation. In ASA grade 1 patients, endoscopic therapy was suggested in 38% of cases after EUS and in 33% after ERC (not significant); in ASA grade 3 patients, it was suggested in 93% of cases. CONCLUSIONS The diagnostic sensitivities of EUS and ERC are similar for extrahepatic cholestasis. ERC is first indicated in poor candidates for surgery, since endoscopic therapy is frequently required. In good candidates for surgery, EUS should be carried out first in order to stage a tumor or identify choledocholithiasis.
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Affiliation(s)
- P Burtin
- Hepatogastroenterology Unit, University Hospital, Angers, France
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16
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Palazzo L, Girollet PP, Salmeron M, Silvain C, Roseau G, Canard JM, Chaussade S, Couturier D, Paolaggi JA. Value of endoscopic ultrasonography in the diagnosis of common bile duct stones: comparison with surgical exploration and ERCP. Gastrointest Endosc 1995; 42:225-31. [PMID: 7498687 DOI: 10.1016/s0016-5107(95)70096-x] [Citation(s) in RCA: 141] [Impact Index Per Article: 4.9] [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: 02/08/2023]
Abstract
An accurate and safe preoperative method of imaging the common bile duct is essential for the proper diagnosis of calculous biliary tract disease, especially in the current era of laparoscopic cholecystectomy. The value of endoscopic ultrasonography in detecting common duct stones has been reported, albeit in small series. The aim of this retrospective study was to assess the accuracy of EUS in a large series of patients. We compared EUS to direct cholangiography in the evaluation of 422 patients for common duct stones. Ductal stones were imaged by EUS in 168 patients (43.4%). No complications were encountered. EUS failed in 2.3% of cases, ERCP failed in 8.3%, and surgical exploration failed in 0.5%. Comparison of EUS with surgical exploration in 185 patients showed a sensitivity of 94.9%, a specificity of 97.8%, and an accuracy of 95.9%. EUS was compared to ERCP in 219 patients. All common duct stones found by ERCP were evident by EUS. Concordance was obtained in 91.3% of cases. Review of videotapes disclosed 3 false-positives and 16 unequivocal true-positives. We conclude that EUS is a safe and highly accurate means of detecting common duct stones and should be proposed before laparoscopic cholecystectomy in patients at risk of choledocholithiasis.
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Affiliation(s)
- L Palazzo
- Service d'hépato-gastro-entérologie, Hôpital Cochin, Université Paris V, France
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Benhamou Y, Caumes E, Gerosa Y, Cadranel JF, Dohin E, Katlama C, Amouyal P, Canard JM, Azar N, Hoang C. AIDS-related cholangiopathy. Critical analysis of a prospective series of 26 patients. Dig Dis Sci 1993; 38:1113-8. [PMID: 8389687 DOI: 10.1007/bf01295729] [Citation(s) in RCA: 82] [Impact Index Per Article: 2.6] [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: 01/30/2023]
Abstract
Several types of biliary tract abnormality of undetermined origin have been described among AIDS patients. The aims of this study are: (1) to evaluate whether biliary tree involvement is in fact one or several homogeneous morphological entities, (2) to specify the role of CMV or Cryptosporidium sp. infection, and (3) to evaluate the possible efficacy of treatment. Since ultrasound had revealed abnormality in the biliary tree, 26 consecutive AIDS patients underwent cholangiography. Cholangiograms enabled us to distinguish between two types of biliary tract involvement: (1) gradual and regular stenosis of the terminal portion of the common bile duct associated with dilation but without irregularity of the intrahepatic biliary ducts was present in 27% of our cases, and (2) distal stenosis of the extrahepatic biliary ducts combined with diffuse irregularity of the caliber of the intrahepatic bile ducts was present in 73% of our cases. Concomitant infection by CMV or Cryptosporidium sp. was significantly more frequent when intrahepatic duct irregularities were present (94%) than when absent (14%, P < 0.001). Anti-CMV treatment and sphincterotomy were unsuccessful in treating anomalies of the intrahepatic biliary tract. Conversely, sphincterotomy caused rapid and lasting disappearance of pain in all our patients. In conclusion, biliary tract involvement in AIDS patients is of two types. CMV infection and infection by Cryptosporidium sp. are most frequent when the large intrahepatic ducts are implicated.
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Affiliation(s)
- Y Benhamou
- Service d'Hépato-Gastroenterologie, Groupe Hospitalier Pitié-Salpétrière, Paris, France
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Bonnel D, Dumont JL, Liguory C, Langlois P, Ziza JM, Cornud F, Lefebvre JF, Canard JM. [Jaundice caused by tuberculous biliary stenosis. Percutaneous treatment]. Presse Med 1988; 17:1586. [PMID: 2971961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
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Liguory CL, Bonnel D, Canard JM, Cornud F, Dumont JL. Intracorporeal electrohydraulic shock wave lithotripsy of common bile duct stones: preliminary results in 7 cases. Endoscopy 1987; 19:237-40. [PMID: 3691404 DOI: 10.1055/s-2007-1018291] [Citation(s) in RCA: 26] [Impact Index Per Article: 0.7] [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: 01/07/2023]
Abstract
We performed contact endobiliary electrohydraulic shock wave lithotripsy in 7 high-risk patient with unextractable common bile duct stones after EPT. The lithotripsy electrode was brought into contact with the stone through a percutaneous transhepatic approach in 5 cases and an endoscopic route in 5 cases. Firing of the shock wave was performed under fluoroscopic control in 4 patients and under endoscopic guidance via a transhepatic percutaneous cholangioscopy in 2 and peroral cholangioscopy in one case. Stones were fragmented in all the cases but one. Fragments were evacuated into the duodenum by simple lavage through the transhepatic drain in 5 cases, and by duodenoscopy in one. In 2 patients, hemobilia, which was controlled by transfusions, was observed. This type of percutaneous contact lithotripsy requires multiple maneuvers, which increase the risk and the hospital stay. Extracorporeal shock wave lithotripsy is simpler, but also has disadvantages. Peroral lithotripsy under endoscopic control performed immediately after EPT would be the most practical solution, but this technique implies the use of new fiberscopes and other energy supplies that are easier to handle.
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Liguory C, Lefebvre JF, Beaugerie L, Bonnel D, Canard JM, Soubielle C, Etienne JP. [Extracorporeal lithotripsy. Preliminary results in 5 patients with calculi of the common bile duct]. Presse Med 1987; 16:1505-7. [PMID: 2958815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Extracorporeal lithotripsy was performed in 5 patients whose stones in the main bile duct could not be extracted despite wide endoscopic sphincterotomy, conventional extraction techniques (basket and balloon catheter) and attempts at mechanical lithotripsy. Fragmentation of the stones was obtained in one session in 4 patients. The fragments were spontaneously expelled in 2 patients, while additional endoscopic manoeuvres (mechanical lithotripsy, extraction after installation of a temporary prosthesis) were necessary in the other 2 patients. Failure in the 5th patient was due to the impossibility to focus the point of convergence of the shock wave on the stones. No complication related to the technique was observed.
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Affiliation(s)
- C Liguory
- Service des Maladies du foie et de l'appareil digestif, Centre hospitalier de Bicêtre, Kremlin
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Liguory C, Lefebvre JF, Canard JM, Bonnel D, Fritsch J, Etienne JP. [Pancreas divisum: clinical and therapeutic study in man. Apropos of 87 cases]. Gastroenterol Clin Biol 1986; 10:820-5. [PMID: 3803823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
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.
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Liguory C, Bonnel D, Canard JM, Lemaire A, Vergeau B, Molinié G. [Instrumental dilation and transparieto-hepatic cholangioscopy for stenosis of a choledocho-duodenal anastomosis with gallstone formation]. Presse Med 1986; 15:481-3. [PMID: 2938092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
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.
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Vilde JL, Marche C, Weinbreck P, Canard JM, Bastin R. [Secondary intestinal effects of antibiotics]. Ann Gastroenterol Hepatol (Paris) 1984; 20:37-40. [PMID: 6529158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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Liguory C, Canard JM. Tumours of the biliary system. Clin Gastroenterol 1983; 12:269-95. [PMID: 6872308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Gastinne H, Canard JM, Pillegand B, Voultoury JC, Catanzano A, Claude R, Gay R. [Oesophagitis during mechanical ventilation]. Nouv Presse Med 1982; 11:3029-3032. [PMID: 6815616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
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.
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Pillegand B, Tournier C, Croguennec B, Lapuelle J, Gérardin A, Canard JM, Menier R, Claude R. [Is it still necessary to order an esophago-gastro-duodenal transit study? Results of a prospective study with a radio-endoscopic comparison]. Gastroenterol Clin Biol 1981; 5:101-2. [PMID: 7202922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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