[Neoplastic jaundice. Percutaneous transhepatic approach to biliary endoprosthesis. 39 cases]. / Ictères néoplasiques. Abord percutané trans-hépatique des endoprothèses biliares. Trente-neuf observations.

Over a 5-year period attempts at transhepatic introduction of a biliary endoprosthesis were made in 39 inoperable patients. The procedure was in 3 stages: transhepatic cholangiography, passage through the stenosis and positioning of the prosthesis. Stenosis was intrapancreatic in 20 cases, pedicular in 9 cases and hilar in 10 cases. The endoprosthesis was successfully set in 20 cases (51%), the success rate being related to the level of the obstacle: intrahepatic 60%, hilar 30%. Failure was more frequent in patients with right liver metastasis, cholangitis or prior unsuccessful palliative surgery. The prosthesis was effective for 1 month in 17 patients and for 6 months or more in 7 patients, two of whom were followed up for 14 and 18 months respectively. Provided patients are better selected and the procedure is used mainly for cholangiocarcinomas, we see no reason why the transhepatic route (combined, if necessary, with endoscopy) should no longer be used to introduce biliary endoprostheses.

[Emergency uterine embolization in postpartum hemorrhage secondary to coagulopathy]. / Embolisation utérine de sauvetage dans une hémorragie de la délivrance secondaire à une coagulopathie.

Acute post-partum hemorrhage secondary to a coagulation disorder was successfully treated by embolization of the uterine arteries. The technique used is described, and the place of embolization as an alternative to surgical procedures discussed.