[The effectiveness of Braun's anastomosis in Billroth II surgery. The role of hepatobiliary sequence scintigraphy (HBSS) in the diagnosis of bile flow following stomach resection]. / Zur Effektivität der Braunschen Fusspunktanastomose bei der Operation nach Billroth II. Stellenwert der hepatobiliären Sequenzszintigraphie (HBSS) bei der Diagnostik des Galleflusses nach Magenresektion.

After resection of the stomach the alkaline reflux of the duodenal contents into the residual stomach is a major factor to be taken into consideration when assessing the causes leading to irregularities of the mucosal barrier. Illnesses that may arise subsequent to gastric surgery are gastritis of the resected stomach, inflammation of the anastomosis, anastomotic ulcers and--with reservations--anastomotic carcinoma. In view of these clinical pictures, a protective function for the biliary system is ascribed to Braun's entero-anastomosis. With the aid of hepatobiliary sequence scintigraphy (HBSS) a functional analysis was obtained from 30 patients, subsequent to gastric surgery--after Billroth II with entero-anastomosis--which showed a surprisingly high rate of reflux into the residual stomach, in 16 out of these 30 patients. The high-grade HBSS data with regard to the biliary reflux proportions after gastric surgery and the low-grade effectiveness of Braun's entero-anastomosis are clearly evidenced.

[Identification and information on patients transfused between 1980 and 1985 at Alexis Vautrin Center]. / Identification et information des transfusés de 1980 à 1985 au Centre Alexis Vautrin.

In 1993, in Centre Alexis Vautrin, we took quite easily the census of 3,170 patients transfused between 1980 and 1985. In our institution, the systematic long-term follow-up of patients treated allowed to select rapidly the patients alive and to ask family doctors to inform and propose screening tests for a possible contamination by HIV and HCV viruses. Out of 802 patients alive, 703 accepted the tests. No contamination by the AIDS virus was detected. Conversely, the survey evidenced positive serology for the virus of Hepatitis C in 16 cases (2.4%).

[Massive transfusion in cancer surgery. A study of the survival of 21 patients]. / Transfusions massives en chirurgie carcinologique. Etude de la survie de 21 malades.

In a retrospective study over 5 years, the evolution of 21 patients who received a massive blood transfusion during a carcinological surgery was analyzed. In this type of surgery, the frequency of massive blood transfusion is 0.28% and affects 2.5% of the patients transfused. In half of the cases, surgery was performed to resect an ovarian cancer. The overall death rate, related to the importance of the blood transfusion, is high: 38% (8 patients out of 21). Among the patients who survived (13), the actuarial survival is low: 10 deaths from local or metastatic disease with a mean survival of 12 months, suggesting that the use of massive blood transfusion was related to the tumoral aggressiveness and to the severity of the deepseated malignant disease.