[Gallbladder volvulus: two cases report]. / Volvulus de la vésicule biliaire : à propos de deux cas.

The authors report two cases of gallbladder volvulus. The diagnosis of this rare pathology is mainly identified preoperatively. Ultrasonographic findings include a "floating gallbladder" with thickened hypoechoic walls. The treatment is emergency cholecystectomy.

[Cystic lymphangioma of the adrenal gland]. / Le lymphangiome kystique de la surrénale.

Cystic lymphangioma of the adrenal gland are rarely encountered tumoural formations with no clinical expression. Preoperative diagnosis is difficult. Echography and CT scan are essential exploratory techniques. Diagnosis is histological. Usually surgical exploration is indicated due to uncertain diagnosis. We report a new case of cystic lymphangioma of the adrenal gland and a review of recent literature.

[Hypersecreting villous rectosigmoid tumors. Apropos of 14 cases]. / Tumeurs villeuses recto-sigmoïdiennes hypersécrétantes. A propos de 14 cas.

Villous recto-sigmoidal tumors with severe fluid and electrolyte loss are rare. We report here fourteen new cases with severe electrolyte imbalance (hypokalemia, hyponatremia, renal failure). We analysed too electrolyte loss in stools and we researched electrocardiographic disorders. Finally, we reported a long-term evolution of these patients.

[Recurrent selective bronchial intubation in laparoscopic cholecystectomy]. / Intubation bronchique sélective à répétition au cours d'une cholécystectomie coelioscopique.

Selective endobronchial intubation occurred three times in a 38-year-old female patient undergoing laparoscopic cholecystectomy. She weighed 58 kg and was 165 cm tall. Anaesthesia was obtained with propofol, fentanyl and vecuronium. Endotracheal intubation was carried out with a Mallinckrodt tube, size 7.5. It was attached to the cheeks with the 22 cm marking at the teeth. The diagnosis of endobronchial intubation was made when he SpO2 fell abruptly to 79, 87 and 93% respectively. Simultaneously, the peak inspiratory pressure increased and PetCO2 decreased. The third time, both lung fields were auscultated; no breath sounds were found on the left side. The first two incidents were cured by exsufflating the artificial pneumoperitoneum. Pulling out the tube 4 cm definitely solved the problem. These endobronchial intubations were due to the tube being too close to the carina. During insufflation of the pneumoperitoneum, the carina is pushed upwards with the corresponding part of the mediastinum.

[Cholecystectomy by celioscopy. Apropos of 126 cases]. / Cholécystectomie par coelioscopie. A propos de cent vingt-six cas.

One hundred twenty-six cases who underwent laparoscopic cholecystectomy were included in the study: 28 males and 98 females with a mean age of 44.2 years. Laparoscopic cholecystectomy was performed for uncomplicated cholelithiasis (111 cases), acute cholecystitis (10 cases), biliary pancreatitis (2 cases) and cholangitis (3 cases). The mean operative time was 78 minutes. In 7 cases, a transformation into open surgery was necessary (5.5%). There were no deaths and one major complication was reported: an iatrogenic injury to the bile duct requiring secondary laparotomy. The mean hospital stay was 3.4 days. However, despite several advantages, this new technique must be performed by a surgeon with experience of biliary tract surgery.

[Does obstructive jaundice adversely affect wound healing? Experimental study in rats (author's transl)]. / L'ictère rétentionnel modifie t-il les processus de cicatrisation?

The effect of obstructive jaundice on wound healing has been investigated in an experimental study of gastric and abdominal wounds in rats following ligation and division of the common bile duct. Our study demonstrates that the obstructive jaundice does not modify the healing of gastric defect whatever the post-operative time. On the opposite, the healing of a parietal defect in these animals showed histological evidence of delayed healing compared with controls. The bursting strength of the abdominal incision was also lowered, but not that of the stomachs. These findings suggest the biochemical changes in the wounds of jaundiced animals interfered with wound repair. The possible causes of this delay in healing and its clinical implications require further investigations by cytokinetic and radioisotope studies.

[Is wound healing modified by the use of diathermy incision (author's transl)]. / La cicatrisation est-elle modifiée par l'utilisation du bistouri électrique?

Many surgeons are hesitant to use the electrocautery on the gastrointestinal tract. The aim of the present study is to compare, with mechanical and histological criteria, wound healing following abdominal and gastric incisions made by scalpel and diathermy, in the rat. This study revealed no difference in bursting pressure between scalpel and diathermy incisions. Histologically there is not a delay in healing in the gastrointestinal tract following electroincision. It is concluded that in abdominal surgery the diathermy can be used without detriment to the strength of any suture line and with no difference in its final healing.