[Retroperitoneal and pancreatic mucinous tumors. Immunohistochemical study]. / Tumeurs mucineuses rétropéritonéales et pancréatique. Etude immunohistochimique.

Examples of mucinous tumors from retroperitoneum (2) and pancreas (1) were studied. These tumors share many morphological similarities with ovarian mucinous tumour and adenoma malignum of uterine cervix. They have a similar spectrum of endocrine cells; serotonin, somatostatin, gastrin and pancreatic polypeptide cells were characterized. In nonproliferative areas was found a well-differentiated mucinous columnar epithelium with scarce endocrine cell. In more proliferative areas were found either a mucinous columnar lining with infolds and secondary glands or a less well-differentiated intestinal-type epithelium with papillary formations; both linings were well supplied in endocrine cells.

[Bacteriology of the bile ducts and antibiotic prophylaxis]. / Bactériologie des voies biliaires et antibioprophylaxie.

The gallbladder wall, gallbladder lumen and bile duct intraoperative sampling materials had been examined in 52 patients with an operation on the biliary tract. All patients were treated by only one infusion before operation: 1 g ceftriaxone was given to 26 patients and 2 g ceftriaxone to the 26 others. Bacterial species were isolated on twenty patients. There was no significant difference in infection rate and organism identity between bacterial flora isolated from patients receiving 1 g ceftriaxone and patients receiving 2 g. Isolated germs were enterobacteriaceae (15) streptococci (14) and anaerobic bacteria (8). The mean count of bacteria in bile is 10(4) germs/ml. Half positive sampling materials contains more than one bacterial strain. The bacterial flora isolated from bile has characteristics of mixed flora infection. Ceftriaxone had a good efficacy in antibiotic prophylaxis.

[Antibiotherapy in biliary surgery. Current status]. / Antibiothérapie en chirurgie biliaire. Etat actuel de la question.

Without antibiotherapy, biliary surgery is often followed by infectious complications, possibly serious, indeed life-threatening. Biliary bacteria do are responsible of these complications; mainly E. Coli, Streptococcus faecalis (whose pathogenicity is disputed) and Klebsiella. Bacteroides fragilis and Pseudomonas aeruginosa are restricted to special circumstances. It is often difficult to presee whether bile is infected: some risk factors were emerged by Keighley but their specificity is not excellent; peroperative Gram staining got various results according to the studies. Some prefer to give a systematic antibiotherapy. Preoperative antibiotic treatment should be as short as possible because it does not sterilize bile, but selects resistant bacteria, which induce postoperative complications. It must mainly be aimed at preventing infectious scattering. Surgery is the main part of the treatment. Antibiotic choice has to take into account clinical picture, bacteria (those probably responsible for and their sensibility) and goal of the treatment (prophylactic or curative). Analysis of failures should allow to improve this choice. But only multicenter studies concerning full selected populations of patients are able to prove superiority of one antibiotic to another.