[Laparoscopic cholecystectomy in elderly patients. Apropos of 115 cases]. / La cholécystectomie coelioscopique chez la personne âgée. A propos de 115 cas.

We report a retrospective analysis of 115 elderly patients over 70 years of age who underwent laparoscopic cholecystectomy for symptomatic lithiasis between January 1990 and January 1996. This technique is perfectly adapted to elderly patients. Complications are less frequent and better tolerated than for conventional open surgery. In this series, the success rate was 97.39% with technique-related complications at 2.7%. None of these complications required reoperation.

[Trans-sutural mechanical anastomosis in esophagogastric surgery. Apropos of 25 cases]. / Anastomose mécanique trans-suturaire dans la chirurgie oeso-gastrique. A propos de 25 observations.

The essential point conditioning the success of a mechanical esophagogastric or esophagojejunal anastomosis is the performance of an esophageal purse. The authors present a variety of the technique which consists of replacing the esophageal purse by a linear stapling after having introduced the anvil in esophagus. The anvil shaft is then exteriorized through the staple line. From January 1991 to January 1994, this technique was performed on 25 patients (17 men and 8 women), with a mean-age of 66 years (range 27 to 83). The esophagojejunal anastomosis after total gastrectomy was performed on 17 patients (15 carcinomas, 1 acute gastritis with gastric haemorrhage, 1 stomal ulcer), and the esophagogastric anastomosis after partial esophagectomy for carcinoma on 8 patients. After six to twelve months neither an anastomotic stenosis nor a leakage occurred. The advantage of this technique is on one hand to simplify the performance of the anastomosis and to reduce the septic and operating time, on the other hand to avoid the complications of performing the esophageal purse.

[Double trans-suture technique in colorectal surgical anastomosis. Apropos of 45 cases]. / Anastomose double trans-suturaire dans la chirurgie colo-rectale. A propos de 45 observations.

The double trans-suture technique in colorectal anastomoses is an entirely mechanical one which consist of the transformation of two linear sutures in a circular one. During, 2 years, between March 1990 and March 1992, this technique was performed on 45 patients, of whom about two-third had a carcinoma of rectosigmoid. No postoperative mortality occurred. One patient developed an anastomatic stenosis, and another one a clinical leakage. The double trans-suture technique has not only the advantages of the double stapling technique but also avoids the incidents of performing a proximal purse.