[Outpatient laparoscopic cholecystectomy]. / Cholécystectomie par laparoscopie en ambulatoire.

UNLABELLED: OUTPATIENT LAPAROSCOPIC CHOLECYSTECTOMY: The laparoscopic technique is the procedure of choice for cholecystectomy. This procedure is done on ambulatory setting in the United States and Europe but no experience was reported in France. AIM OF THE STUDY: To report the organisation and results of our initial 100 consecutive patients operated for a laparoscopic cholecystectomy on an outpatient basis. PATIENTS AND METHODS: After assessment of the prevention of pain and nausea or vomiting after laparoscopic cholecystectomy on hospitalized patients, a prospective trial was done on our first 100 patients for outpatient laparoscopic cholecystectomy on routine basis. RESULTS: During the period, 27.4% of patients were entered on an ambulatory basis. 72% of patients did not need any medication post-operatively in the structure. 17 patients were admitted: in five cases, decision was done pre-operatively, one patient went back home against medical advising; in three cases, peroperatively, and in 10 cases postoperatively. Four patients were readmitted between the fifth and sixteenth post-operatoire day. CONCLUSION: An adequate organisation for day case surgery, a good selection of patients on medical, surgical and environmental criteria, simple procedures to prevent pain or nausea vomiting post-operatively allow use to assert that hospitalisation is unjustified for laparoscopic cholecystectomy in a quater of patients.

[Bronchogenic esophageal cysts in the adult. Four cases]. / Kystes oesophagiens bronchogéniques de l'adulte. Quatre observations.

Bronchogenic oesophageal cysts possess a mucosa of the airway type but are unconnected to the tracheobronchial tree; they are in close anatomical relation with the oesophageal wall. These characteristics are explained by the fact that the respiratory and digestive tract share the same embryonic development. Four cases of bronchogenic oesophageal cyst are reported, and 21 well-documented cases from the literature are reviewed. The lesion is extremely rare in adults, often complicated and responsible for gastrointestinal, respiratory and sometimes even cardiac symptoms. Its features at radiology, endoscopy and computerized tomography are suggestive of the diagnosis. Treatment consists of excision by enucleation. Excision must be complete for recurrences to be avoided.

[Isolated traumatic rupture of the gallbladder. Apropos of a case]. / Rupture traumatique isolée de la vésicule biliaire. A propos d'un cas.

A case of isolated rupture of the gallbladder following a closed injury to the abdomen is reported. Various anatomical forms of this very rare lesion have been described. The mechanism, diagnosis, and treatment of this traumatic lesion are discussed, based on a review of the published literature.

[Ectopic openings of the common bile duct. A contribution to the physiological study of the sphincter of Oddi (author's transl)]. / Les abouchements ectopiques du cholédoque. Contribution à l'étude de la physiologie du sphincter d'Oddi.

Two cases of ectopic openings of the common bile duct are reported. In one case there was a congenital short duct opening into DI, the presence of a spontaneous duodenobiliary reflux due to absence of the papilla being demonstrated by clinical and radiological examinations. The other patient had a long duct opening into D3 and no duodenobiliary reflux, but with an intact sphincter of Oddi explored in detail by means of combined choledochoduodenal manometry. These two cases demonstrate that the duodenal wall has only a moderate effect in preventing duodenobiliary reflux. The essential element is the sphincter of Oddi: if present, there is no reflux, if absent, reflux occurs.