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See detailContribution to the care of patients suffering from terminal liver failure
Detry, Olivier ULg

Thèse d’agrégation de l’enseignement supérieur (2007)

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See detailProlonged anhepatic state after early liver graft removal
Detry, Olivier ULg; De Roover, Arnaud ULg; Delwaide, Jean ULg et al

in Hepato-Gastroenterology (2007), 54(79, Oct-Nov), 2109-2112

Two-stage liver transplantation, i.e. salvage emergent total hepatectomy with prolonged anhepatic state, and subsequent liver transplantation, has been described as a life-saving procedure in selected ... [more ▼]

Two-stage liver transplantation, i.e. salvage emergent total hepatectomy with prolonged anhepatic state, and subsequent liver transplantation, has been described as a life-saving procedure in selected cases. The principal drawback of two-stage liver transplantation is the fact that anhepatic patient survival only depends on the future availability of a liver graft. The pathophysiologic alterations induced by total hepatectomy are not fully known, as it is not known how long a patient may be anhepatic before it is too late for hope of survival. In this report the authors describe the cases of three liver recipients who had to undergo salvage liver graft removal early during or after liver transplantation as a life-saving maneuver. All were afterwards registered for emergent liver retransplantation. Mean anhepatic period was 20 hours (Range: 17-24 hours). Two patients survived and fully recovered. From this experience and from other cases reported in the literature, the authors concluded that total hepatectomy may be life-saving in some cases if a liver graft is available in a timely manner. [less ▲]

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See detailPrevention and treatment of major blood loss
Detry, Olivier ULg; De Roover, Arnaud ULg; Honore, Pierre ULg

in New England Journal of Medicine [=NEJM] (2007), 357(12), 1261-1261

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See detailConfrontation anatomo-clinique: duplication caecale
Scagnol, Irène ULg; Detry, Olivier ULg; de Leval, Laurence ULg et al

in Revue Médicale de Liège (2007), 62(2), 118-21

Enteric duplication cysts, and particularly caecal duplication cysts, are rare and generally benign congenital anomalies for which a diagnosis is difficult to make because they mimic other surgical ... [more ▼]

Enteric duplication cysts, and particularly caecal duplication cysts, are rare and generally benign congenital anomalies for which a diagnosis is difficult to make because they mimic other surgical diseases. A surgical management is the treatment of choice. The diagnosis can then be made or confirmed by histopathologic analysis. [less ▲]

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See detailHepatobiliary disease : primary and metastatic liver tumours
Hustinx, Roland ULg; Detry, Olivier ULg

in Cook, Gary JR; Maisey, Michael M; Britton, Keith (Eds.) et al Clinical Nuclear Medicine (2007)

PET and PET-CT in Oncology describes the principles of positron emission tomography and is a useful resource for incorporating the technique in clinical practice. In a clear and straightforward fashion ... [more ▼]

PET and PET-CT in Oncology describes the principles of positron emission tomography and is a useful resource for incorporating the technique in clinical practice. In a clear and straightforward fashion, this heavily-illustrated text offers instructive information and overviews of the basic principles of PET and PET-CT as well as the routine clinical PET scanning procedures for all important oncological indications. It is designed to serve as a reference work for specialists in nuclear medicine and radiology (including therapy planning) and for oncologists. It also provides student and physicians in other medical specialities with a general introduction to the effective integration of this modern technique into routine clinical diagnostics. Above all, this volume illustrates the importance of PET and PET-CT in comparison with other imaging techniques. [less ▲]

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See detailComplications in living liver donor according to Clavien's classification: An European experience
De Roover, Arnaud ULg; Detry, Olivier ULg; Meurisse, Nicolas ULg et al

in Journal of Hepatology (2007), 46(Suppl. 1), 66

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See detailCadaveric liver transplantation for non-acetaminophen fulminant hepatic failure: A 20-year experience
Detry, Olivier ULg; De Roover, Arnaud ULg; Coimbra Marques, Carla ULg et al

in World Journal of Gastroenterology (2007), 13(9), 1427-1430

AIM: To investigate the long-term results of liver transplantation (LT) for non-acetaminophen fulminant hepatic failure (FHF). METHODS: Over a 20-year period, 29 FHF patients underwent cadaveric whole LT ... [more ▼]

AIM: To investigate the long-term results of liver transplantation (LT) for non-acetaminophen fulminant hepatic failure (FHF). METHODS: Over a 20-year period, 29 FHF patients underwent cadaveric whole LT. Most frequent causes of FHF were hepatitis B virus and drug-related (not acetaminophen) liver failure. All surviving patients were regularly controlled at the out-patient clinic and none was lost to follow-up. Mean follow-up was 101 mo. RESULTS: One month, one-, five- and ten-year patient survival was 79%, 72%, 68% and 68%, respectively. One month, one-, five- and ten-year graft survival was 69%, 65%, 51% and 38%, respectively. Six patients needed early (< 2 mo) retransplantation, four for primary non-function, one for early acute refractory rejection because of ABO blood group incompatibility, and one for a malignant tumor found in the donor. Two patients with hepatitis B FHF developed cerebral lesions peri-transplantion: One developed irreversible and extensive brain damage leading to death, and one suffered from deep deficits leading to continuous medical care in a specialized institution. CONCLUSION: Long-term outcome of patients transplanted for non-acetaminophen FHF may be excellent. As the quality of life of these patients is also particularly good, LT for FHF is clearly justified, despite lower graft survival compared with LT for other liver diseases. (C) 2007 The WJG Press. All rights reserved. [less ▲]

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See detailBloodless cadaveric liver transplantation: Experience with Jehovah's witness recipients
Detry, Olivier ULg; De Roover, Arnaud ULg; Coimbra Marques, Carla ULg et al

in Journal of Hepatology (2007), 46(Suppl. 1), 67

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See detailActualites en chirurgie et transplantation hepatique
Detry, Olivier ULg; De Roover, Arnaud ULg; Coimbra Marques, Carla ULg et al

in Revue Médicale de Liège (2007), 62(5-6, May-Jun), 310-6

Over the last 20 years, significant improvements in hepatic surgery and transplantation have allowed better results. Better patients selection, new preoperative modalities aiming at modifying the volume ... [more ▼]

Over the last 20 years, significant improvements in hepatic surgery and transplantation have allowed better results. Better patients selection, new preoperative modalities aiming at modifying the volume of the liver or the tumour, new surgical techniques, and better postoperative management are the keys to improved outcome. These progresses are reviewed in this article. In hepatic surgery, the latest surgical improvements are the possibility of laparoscopic hepatic resection and of radiofrequency ablation. Modern neoadjuvant chemotherapy may in some cases allow a reduction of large liver colorectal metastases and render them resectable. Improved radiological techniques allow better planning of the surgical resections, reduction of the risks by calculation of the residual liver mass, and induction of liver hypertrophy by preoperative portal embolisation. In liver transplantation, the most significant changes were the use of living related liver donors and of non-heart beating donors to overcome the cadaveric organ donor shortage. [less ▲]

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See detailBrain edema and intracranial hypertension in fulminant hepatic failure: Pathophysiology and management
Detry, Olivier ULg; De Roover, Arnaud ULg; Honore, Pierre ULg et al

in World Journal of Gastroenterology (2006), 12(46), 7405-7412

Intracranial hypertension is a major cause of morbidity and mortality of patients suffering from fulminant hepatic failure. The etiology of this intracranial hypertension is not fully determined, and is ... [more ▼]

Intracranial hypertension is a major cause of morbidity and mortality of patients suffering from fulminant hepatic failure. The etiology of this intracranial hypertension is not fully determined, and is probably multifactorial, combining a cytotoxic brain edema due to the astrocytic accumulation of glutamine, and an increase in cerebral blood volume and cerebral blood flow, in part due to inflammation, to glutamine and to toxic products of the diseased liver. Validated methods to control intracranial hypertension in fulminant hepatic failure patients mainly include mannitol, hypertonic saline, indomethacin, thiopental, and hyperventilation. However all these measures are often not sufficient in absence of liver transplantation, the only curative treatment of intracranial hypertension in fulminant hepatic failure to date. Induced moderate hypothermia seems very promising in this setting, but has to be validated by a controlled, randomized study. Artificial liver support systems have been under investigation for many decades. The bioartificial liver, based on both detoxification and swine liver cells, has shown some efficacy on reduction of intracranial pressure but did not show survival benefit in a controlled, randomized study. The Molecular Adsorbents Recirculating System has shown some efficacy in decreasing intracranial pressure in an animal model of liver failure, but has still to be evaluated in a phase Ill trial. (c) 2006 The WJG Press. All rights reserved. [less ▲]

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See detailRisk of upper gastrointestinal cancer after bariatric operations
De Roover, Arnaud ULg; Detry, Olivier ULg; Desaive, Claude ULg et al

in Obesity Surgery (2006), 16(12), 1656-1661

The authors discuss the potential influence of obesity surgery on the risk of cancer, focusing on the upper GI tract directly affected by operations. There is currently no substantiation for an increased ... [more ▼]

The authors discuss the potential influence of obesity surgery on the risk of cancer, focusing on the upper GI tract directly affected by operations. There is currently no substantiation for an increased risk of cancer after bariatric surgery, because there are only about 25 reports of subsequent cancer of the esophagus and the stomach. However, this review emphasizes the need to detect potential precancerous conditions before surgery. Candidates for postoperative endoscopic surveillance may include patients >15 years after gastric surgery, but also patients symptomatic for gastroesophageal reflux disease in whom a high incidence of Barrett's metaplasia has been reported. The greatest concern is a delay in diagnosis from inadequate investigation due to mistaking serious upper GI symptoms as a consequence of the past operation. [less ▲]

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See detailReport of two cases of gastric cancer after bariatric surgery: Lymphoma of the bypassed stomach after Roux-en-Y gastric bypass and gastrointestinal stromal tumor (GIST) after vertical banded gastroplasty
De Roover, Arnaud ULg; Detry, Olivier ULg; de Leval, Laurence ULg et al

in Obesity Surgery (2006), 16(7), 928-931

We report two new cases of gastric cancer diagnosed after a bariatric operation. The first case is a 66-year-old male who 3 years after gastric bypass suffered from a perforation of the fundus that was ... [more ▼]

We report two new cases of gastric cancer diagnosed after a bariatric operation. The first case is a 66-year-old male who 3 years after gastric bypass suffered from a perforation of the fundus that was found to be secondary to a diffuse large B-cell lymphoma of the distal stomach. The second case is a 47-year-old woman who presented 12 years after a vertical banded gastroplasty with a gastric pouch outlet obstruction caused by a gastrointestinal stromal tumor (GIST). Based on the few reports of cancer in the literature, analysis of these cases suggests that the main risk of gastric cancer after bariatric surgery comes from the delayed diagnosis of malignancy. [less ▲]

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See detailEmergency graft removal after liver transplantation
Detry, Olivier ULg; De Roover, Arnaud ULg; Delwaide, Jean ULg et al

in Liver Transplantation (2006, May), 12(5), 72

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See detailSelective coil occlusion of a large arterioportal fistula in a liver graft
Detry, Olivier ULg; De Roover, Arnaud ULg; Delwaide, Jean ULg et al

in Liver Transplantation (2006), 12(5), 888-889

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See detailAdjuvant hyperthermic intraperitoneal peroperative chemotherapy (HIPEC) Associated with curative surgery for locally advanced gastric carcinoma.An initial experience
De Roover, Arnaud ULg; Detroz, Bernard ULg; Detry, Olivier ULg et al

in Acta Chirurgica Belgica (2006), 106(3), 297-301

Aim of the study : After macroscopic radical (R0) surgery for advanced gastric carcinoma, 40 to 50% of the tumors recur in the abdomen as locoregional or peritoneal disease. We initiated a protocol in ... [more ▼]

Aim of the study : After macroscopic radical (R0) surgery for advanced gastric carcinoma, 40 to 50% of the tumors recur in the abdomen as locoregional or peritoneal disease. We initiated a protocol in which patients with suspicion of macroscopic serosal, lymphatic or peritoneal invasion, treated with R0 resection, underwent adjuvant HIPEC. Methods : Between June 1998 and January 2003, 16 patients with locally advanced adenocarcinoma of the stomach were included in the study. Surgery consisted of a total gastrectomy with a D2 lymphadenectomy. Splenectomy (n = 1), splenopancreatectomy (n = 4), transverse colectomy (n = 3), left hepatectomy (n = 1), localized peritonectomy (n = 3) were associated to obtain a R0 resection. HIPEC protocol consisted of heated (42.5°C) intraperitoneal mitomycin C (15 mg/m2) for a planned duration of 90 minutes. Results : HIPEC median duration was limited to 73(20-90) min because of central hyperthermia recognition in half of the cases. One patient died in the postoperative period of sepsis secondary to a duodenal fistula. Postoperative morbidity included pancreatic fistula (n = 2), pulmonary oedema (n = 1), pulmonary embolus (n = 1) and transient renal failure (n = 1). UICC staging was IB (n = 2), II (n = 2), IIIA (n = 5), IIIB (n = 1), IV (n = 6). Nine of the 16 patients are alive without recurrence with a median follow-up of 52 months. Four patients developed a recurrence, intraperitoneal (n = 2), systemic (n = 1), or combined (n = 1). Two patients were lost to follow-up. Conclusions : Aggressive surgical therapy and HIPEC might represent the standard of care in a selected population with locoregional disease and for whom a R0 resection can be achieved. This protocol was associated in this study with a 75% 5-year survival with a low peritoneal recurrence rate and an acceptable morbidity. [less ▲]

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See detailCancer risk and bariatric surgery
De Roover, Arnaud ULg; Desaive, Claude; Detry, Olivier ULg et al

in Obesity Surgery (2006), 16

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See detailCarcinoid tumor of the appendix: A consecutive series from 1237 appendectomies
Tchana-Sato, Vincent ULg; Detry, Olivier ULg; Polus, Marc ULg et al

in World Journal of Gastroenterology (2006), 12(41), 6699-6701

AIM: To report the experience of the CHU Sart Tilman, University of Liege, Belgium, in the management of appendiceal carinoid tumor. METHODS: A retrospective review of 1237 appendectomies performed in one ... [more ▼]

AIM: To report the experience of the CHU Sart Tilman, University of Liege, Belgium, in the management of appendiceal carinoid tumor. METHODS: A retrospective review of 1237 appendectomies performed in one single centre from January 2000 to May 2004, was undertaken. Analysis of demographic data, clinical presentation, histopathology, operative reports and outcome was presented. RESULTS: Among the 1237 appendectomies, 5 appendiceal carcinoid tumors were identified (0.4%) in 4 male and 1 female patients, with a mean age of 29.2 years (range: 6-82 years). Acute appendicitis was the clinical presentation for all patients. Four patients underwent open appendectomy and one a laparoscopic procedure. One patient was reoperated to complete the excision of mesoappendix. All tumors were located at the tip of the appendix with a mean diameter of 0.6 cm (range: 0.3-1.0 cm). No adjuvant therapy was performed. All patients were alive and disease-free during a mean follow-up of 33 mo. CONCLUSION: Appendiceal carcinoid tumor most often presents as appendicitis. In most cases, it is found incidentally during appendectomies and its diagnosis is rarely suspected before histological examination. Appendiceal carcinoid tumor can be managed by simple appendectomy and resection of the mesoappendix, if its size is <= 1 cm. (C) 2006 The WJG Press. All rights reserved. [less ▲]

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See detailPylephlebitis of the portal vein complicating intragastric migration of an adjustable gastric band
De Roover, Arnaud ULg; Detry, Olivier ULg; Coimbra Marques, Carla ULg et al

in Obesity Surgery (2006), 16(3), 369-371

Pylephlebitis, or septic thrombophlebitis of the portal vein, is an infrequent but life-threatening complication of abdominal septic events. The authors report the occurrence of pylephlebitis and multiple ... [more ▼]

Pylephlebitis, or septic thrombophlebitis of the portal vein, is an infrequent but life-threatening complication of abdominal septic events. The authors report the occurrence of pylephlebitis and multiple liver abscesses induced by a neglected intra-gastric migration of an adjustable silicone gastric band. The patient was successfully treated by broad-spectrum antibiotics and total gastrectomy with Roux-en-Y esophagojejunostomy. Postoperative recovery was marked by acute liver failure that was managed conservatively. The patient is alive and well at 1-year follow-up. This case emphasizes the interest in early removal of the band when intra-gastric migration is diagnosed. [less ▲]

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See detailOutcome of patients with hepatocellular carcinoma listed for liver transplantation within the eurotransplant allocation system
Adler, M.; Lerut, J.; Starkel, P. et al

in Journal of Hepatology (2006), 44(Suppl. 2), 14

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