Chirurgie; mémoires de l'Académie de chirurgie
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Review Comparative Study
[Pancreatojejunostomy or pancreatogastrostomy after cephalic pancreatoduodenectomy].
The propensity for leakage at the site of pancreatojejunostomy continues to be a major reason for morbidity and death after pancreaticoduodenectomy. Pancreatogastrostomy has been introduced as a possible alternative to pancreatojejunostomy and although this procedure was developed experimentally more than 50 years ago its use has not gained widespread clinical use. ⋯ Pancreatogastrostomy was performed in 15 patients with pancreatic resection for carcinoma and compared with 57 pancreatojejunostomy. Our experience confirms that pancreatogastrostomy is a safe and easy method and suggest that it may be used more frequently.
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Randomized Controlled Trial Clinical Trial
[Relation between oxygen delivery and consumption during septic states. Value of an early dobutamine test].
From previous studies it has been hypothesized that multiple organ failure and high level of mortality, seen in critically ill septic patients, may be due to defective oxygen extraction and tissue hypoxia occurring early in the course of sepsis. Oxygen flux test has been proposed as a method of revealing an occult oxygen debt. We used a one hour dobutamine infusion test, in septic patients, without increase in blood lactate. ⋯ The RD+ patients improved more rapidly when compared with RD-, NRD+, NRD-. We concluded that a one hour dobutamine test is able to identify R and NR critically ill septic patients. The response is associated with significant difference in outcome.(ABSTRACT TRUNCATED AT 250 WORDS)