Experimental pancreatic cancer in the rat treated by photodynamic therapy.

Selective histological necrosis of experimental pancreatic carcinoma by photodynamic therapy (PDT) has been successful with haematoporphyrin derivatives and phthalocyanine as photosensitizers. This report describes the feasibility of PDT with pheophorbide A as the photosensitizer to treat azaserine-induced pancreatic rat carcinoma and analyses survival of the animals. An organ distribution study 24 h after pheophorbide A administration (9 mg/kg intravenously) gave a selectivity ratio of 13.5:1 between tumour and surrounding tissue. Light of 660 nm and 100 J/cm2 induced selective necrosis of the tumour. Six of nine rats were cured in 120 days whereas all 36 control animals died within 35 days (P < 0.01). The pancrease and hepatic pedicle were relatively unaffected by PDT, but the duodenum was injured.

[Fundoplication by the Nissen-Rosetti technique using celioscopy. 10 cases]. / Fundoplicature selon Nissen-Rossetti par coelioscopie. 10 observations.

Ten patients presenting with hiatus hernia and gastro-oesophageal reflux underwent laparoscopic Nissen-Rossetti fundoplication. All patients had either medical treatment failure or invalidating reflux. At present, complete fundoplication is the most effective surgical treatment of gastro-oesophageal reflux. The laparoscopic procedure was rigorously identical with the habitually used "open" procedure, the only difference being the abdominal access. No laparotomy was necessary in our patients, and no major complication was observed. The follow-up showed good clinical results. Laparoscopy has been reported to decrease postoperative pain and ventilatory disorders. Morover, this minimally invasive surgical technique enables rapid resumption of social and professional activities.

[Severe complications after cholecystectomy by celioscopy: lessons from yesterday and today]. / Graves complications après cholécystectomie par coelioscopie: leçons d'hier et d'aujourd'hui.

The case of a series of grave complications after a laparoscopic cholecystectomy is reported: a common bile duct section diagnosed rather late, hemoperitoneum, inappropriate common bile duct reconstruction and late anastomic leakage, stenosis of an hepatico-jejunal anastomosis, haemorrhage through the external biliary drainage and iterating sepsis. The final outcome was good. The stenotic hepatico-jejunal anastomosis was dilated by a Gianturco self-expanding prosthesis percutaneously placed. As an evidence, this alternative treatment is only exceptional, the treatment of choice for postsurgical benign strictures being surgical repair.