Lestraumatismes de la VBP au cours des contusions de l'abdomen

The bile duct ruptures during abdominal contusions are uncommon and require often a violent trauma, Their mechanism is stilt unknown, but the theory of wrench of choledochus, firmly fixed to duodenum, by liver pressed back at the time of trauma in the diaphragmatic concavity, seems to be the very likely. Indeed, the seat of the lesion is most often at the junction between pedicular choledochus and retropancreatic choledochus, and it can be either partial or total. In general, it is diagnosed in peroperative stage and its diffIculty depends on the lesion type. The effective therapeutical management lies in the direct or canal suture associated or not to the kehr's drainage. The bilio-digestive anastomosis can be used when repair end to end is impossible. Secondary bile duct stenosis can occur in the operative sequelae

vagotomie supra-selective dans le traitement de l'ulcere duodenal resultats preliminaires de 65 observations

The authors bring in the results of 65 VSS realised in Surgery [A Pr A. MAANOUNI]. Preliminary call is explained by the fact that it is not a long time ago that some patients underwent this operation. 37 patients are operated of a non complicated ulcer, resistant to a medical aid. 28 are operated on complicated ulcers, 13 of them are of stenosis. Studies on notes give an account of the quality of the functional results [89% VISICK I - II] of this mild operation [death rate zero] whose recurrence rate [6.7%] can be correlated to the one obtained with the other pattern of " vagotomy " that requires a notion of drain. The gastric stasis pre-operative is admitted as being the main factor in the therapeutic failure

[Surgical traumas of the main biliary duct]

The authors report 21 cases of operative traumatisms of the main biliary duct seen at the Medical School Hospitals of Rabat and Casablanca between 1971 and 1979. Eight accidents immediately admitted during the surgical procedure have been repaired with success. Thirteen accidents operated on secondarily ended in 3 deaths and 10 favourable results. The authors analyze the gravity factors of the complications dominated by the angiocholitis, the restenosis and the evolution to the biliary cirrhosis