[Sclerosing cholangitis and biliary sequelae of hydatid cyst of the surgically treated liver]. / Cholangites sclérosantes et séquelles biliaires du kyste hydatique du foie opéré.

Worldwide literature and ten or so personal cases are reviewed as a basis for distinction or intrication of two aspect of post-hydatid sclerosing cholangitis; that of a localized lesion of diffuse lesions of the biliary tract. In both cases the action of the hydatid cyst is not due to toxins but to pressure on biliary duct walls, very variable according to site and size. This local action may be the only cause, provoking a specific type of lesion, a true sequela of an incomplete or delayed operation. In certain regions, or in the presence of biliary stasis and angiocholitis, passage of hydatid fluid into biliary tracts, normally tolerated by healthy biliary pathways, leads to a diffuse sclerosing cholangitis. The serious consequence of this eventuality is proved by the failure of many treatments, with subsequent inevitable liver transplants. Clinical circumstances and data explaining this complication allow necessary precautions to be taken. Furthermore, early treatment of hydatidosis or as radical as possible therapy for advanced lesions is curative of localized forms of the disease.

A curative surgical approach to gallbladder carcinoma in its early stages.

The study is based on 20 personal cases of gallbladder cancer and 254 similar cases from five surgical departments. The contradictory results obtained by surgery are explained by the special structure of the gallbladder wall and the bipolar connections with the liver and lymphatic ducts. Personal experience and literature reports evidence the possibility of cure for various stages: macroscopic lesions, while qualified as early stages are actually already advanced and necessitate extended liver resection with considerable lymph node dissections; the so-called early stage, detectable solely by histology, is harmful since the entire thickness of the mucosa is involved and always requires enlarged cholecystectomy to include the liver and lymph nodes. In this case good survival rates are possible; in situ pre-epithelial lesions diagnosed by cytology, are amenable to cure by simple cholecystectomy. Prevention rests on a wide range of indications for cholecystectomy (lithiasis, female sex, age over 50 years).

[Hepatic resection as necessary in liver injuries]. / La résection hépatique "à la demande" dans les traumatismes du foie.

The fact that experience has been gained during four successive episodes since 1940 emphasizes the progress accomplished in the fields of therapeutic indications and surgical techniques for these lesions. Resection "on request" is effective both as therapy of hemorrhage and escape of bile: conducted under the control of regional hemostasis it is the most sparing of healthy parenchyma while being effective and complete. It can be adapted for emergency cases, or used as first intention surgery as well as in delayed cases or previously operated patients. Results are particularly interesting in the absence of associated lesions.

[Therapeutic problems in cancer of the liver. Significance of the vascular quotient]. / Problèmes thérapeutiques posés par les cancers du foie. Intérêt du quotient vascùlaire.

The therapeutic problems investigated are orientated on the good results obtained by certain hepatic resections. The reasons for their success is discussed from the point of view of the patient's state of immunity, the technic employed, and the characteristics of the tumor. Under characteristics of the tumor are discussed : biologic reactions, anatomic and histologic aspects, and especially the vascular quotient which, studied entirely from the experimental point of view, includes the arterial, venous and lymphatic aspects for each variety of cancer. These findings can be classified and compared with the results obtained. This retrospective study opens the way for a prospective classification aimed at confirming the therapeutic views. A principle preoccupation is the detection of cases with only local involvement where cure is possible, while therapeutic trials for lesions with regional extension are to be tested.

[Perforations of the colon and rectum during administration of barium enema. Six cases report (author's transl)]. / Les perforations recto-coliques au cours du lavement baryté. A propos de six observations.

Perforations of the colon and rectum during administration of barium enema. Six cases report. The authors have stated six cases of accidental perforation occurring during barium enema examination. They recall their principal modality of unexpected arrival, in particular: the type of nozzle used, the means of injecting the contrasting liquid, the role played by the pathological associated colon-rectum lesions. The diagnosis may be postponed especially when the perforation is under the peritoneal seat. The pain during or after the opacification as well as the rectorragies are the most frequent alarming symptoms observed. The prognosis is on the whole serious but is can be improved by a rapid and appropriate therapy.