[Gastric necrosis following gastroplasty]. / Nécrose gastrique après gastroplastie.

INTRODUCTION: Over the past ten years, laparoscopic surgery in the treatment of morbid obesity has expanded. However, there are few publications describing its side effects, notably the occurrence of gastric necrosis. OBSERVATION: Two years after laparoscopic-banding for morbid obesity, a case of acute gastroenteritis in a 45 Year-old woman proved to be a gastric necrosis. COMMENTS: Relatively unknown, this complication is generally revealed by non-specific clinical signs. Only emergency oeso-gastro-duodenal opacification permits diagnosis. Early diagnosis permits conservative treatment before the onset of necrosis. CONCLUSION: Care must be taken when using this technique, which has not yet proved its innocuousness, and regular follow-up of the patient is crucial.

[Radiofrequency ablation of hepatocellular carcinoma in patients with cirrhosis]. / Traitement par radiofréquence des carcinomes hépatocellulaires sur cirrhose.

UNLABELLED: Radiofrequency is an effective therapeutic modality for patients with hepatocellular carcinoma. However few data are available with regard to the complication rate, the feasibility and long term survival. AIMS: To assess the response rate and complications of radiofrequency in cirrhotic patients with hepatocellular carcinoma. PATIENTS AND METHODS: Eighteen patients were enrolled. Each nodule was treated subcutaneously. Treatment response was assessed by computed tomography performed at 24 hours in 10 patients and every 3 months in all patients. Necrosis of the tumor was considered complete when hypodensity without enhanced contrast. RESULTS: Thirty hepatocellular carcinoma nodules with a mean tumor size of 30 mm; 15<30 mm and 15 >=30 mm, were treated by 1.3 radiofrequency sessions. Complete necrosis was achieved in 89%, greater for nodules<30 mm (100%) than for nodules >=30mm (80%). After a median follow up of 10.6 months, survival rate was 50%. Death was related to tumor involvement in 28%, to cirrhosis complications in 17% and to non liver-related disease in 5%. Three major treatment-related complications occurred (10%): subcapsular hematoma, sustained severe pain and peritoneal dissemination. All three complications were related to subcapsular location. CONCLUSION: Radiofrequency may be considered as an alternative treatment to percutaneous ethanol injection for hepatocellular carcinoma; however, subcapsular location has to be excluded when considering the observed morbidity. Prospective studies are warranted to evaluate the efficacy and morbidity of this treatment in hepatocellular carcinoma.