Rubber transcystic drainage reduces the post-removal biliary complications in liver transplantation: a matched case-control study.

PURPOSE: Bile duct (BD) complications continue to be the "Achilles' heel" of liver transplantation, and the utilization of bile duct drainage is still on debate. We describe the results of a less invasive rubber trancystic biliary drainage (TBD) compared to a standard silicone T-tube (TT). METHODS: The transplanted patients (n = 248), over a period of 5 years with a TBD (n = 20), were matched 1:2 with control patients with a TT (n = 40). Primary end points were the overall incidence of BD complications and graft and patient survival. Secondary end points included the complications after the drainage removal. RESULTS: Although the bile duct leakage rates were not significantly different between both groups, the TT group had a significantly higher rate of overall 1-year BD stenosis (40 versus 10 %) (p = 0.036). Three-year patient/graft survival rates were 83.2/80.1 and 84.4/84.4 % for the TT and TBD groups, respectively. The postoperative BD complications, after drainage removal (peritonitis and stenosis), were significantly reduced (p = 0.011) with the use of a TBD. CONCLUSION: The use of rubber TBD in liver transplant recipients does not increase the number of BD complications compared to the T-tube. Furthermore, less BD anastomotic stenosis and post-removal complications were observed in the TBD group compared to the TT group.

[Surgical management of a preaortic paraganglioma: Report of one case]. / Prise en charge chirurgicale d'un paragangliome préaortique: à propos d'un cas.

Paragangliomas (PG) are rare and often diagnosed in the young adult. One case of retroperitoneal preaortic paraganglioma localised between the celiac trunk and the superior mesenteric artery is reported. The management of paraganglioma involves endocrinologists, geneticists and surgeons but the only potentially curative treatment remains surgical resection. Pathology reports can not always discriminate between benign or malignant tumors. Hereditary in paraganglioma occurs in approximately 25% of cases. Genetic investigation is therefore mandatory in all patients with PG. Since the type of genetic mutation is correlated with tumoral aggressiveness, genetic investigation results should be taken into account when a surgical procedure is planned.

[Complicated diverticulitis during pregnancy]. / Diverticulite sigmoïdienne compliquée en cours de grossesse.

The authors report a case of perforated diverticulitis with presence of a fistulous tract between a peridiverticular abscess and the uterus during pregnancy with favorable outcome under medical treatment. The purpose of this case report is to illustrate specific imaging findings and clinical management of diverticulitis during pregnancy.