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| 1 | Pancreatic head cancer in patients with chronicpancreatitis显示文摘BACKGROUND: Chronic pancreatitis (CP) is a risk factor of pancreatic adenocarcinoma (PA). The discovery of a pancreatic head lesion in CP frequently leads to a pancreaticoduo denectomy (PD) which preceded by a multidisciplinary meeting(MM). The aim of this study was to evaluate the relevance between this indication of PD and the definitive pathological results.METHODS: Between 2000 and 2010, all patients with CP who underwent PD for suspicion of PA without any histological proof were retrospectively analyzed. The operative decision has always been made at an MM. The definitive pathological finding was retrospectively confronted with the decision made at an MM, and patients were classified in two groups according to this concordance (group 1) or not (group 2). Clinical and biological parameters were analyzed, preoperative imaging were reread and confronted to pathological findings in order to identify predictive factors of malignant degeneration.RESULTS: During the study period, five of 18 (group 1) patients with CP had PD were histologically confirmed to have PA, and the other 13 (group 2) did not have PA. The median age was52.5 ±8.2 years (gender ratio 3.5). The main symptoms were pain (94.4%) and weight loss (72.2%). There was no patient's death. Six (33.3%) patients had a major complication (ClavienDindo classification ≥3). There was no statistical difference in clinical and biological parameters between the two groups. The rereading of imaging data could not detect efficiently all patients with PA.CONCLUSIONS: Our results confirmed the difficulty in detecting malignant transformation in patients with CP before surgery and therefore an elevated rate of unnecessary PD was found. A uniform imaging protocol is necessary to avoid PD as a less invasive treatment could be proposed. | Aude Merdrignac Laurent Sulpice Michel Rayar Tanguy Rohou Emmanuel Quéhen Ayman Zamreek Karim Boudjema Bernard Meunier | 2014 | Hepatobiliary & Pancreatic Diseases International2014，13，2： | 6 |
| 2 | Comparison of alternative arterial anastomosis site during liver transplantation when the recipient’s hepatic artery is unusable显示文摘Background:Few studies have analyzed outcomes of liver transplantation(LT)when the recipient hepatic artery(HA)was not usable.Methods:We retrospectively evaluated the outcomes of LT performed using the different alternative sites to HA.Results:Between 2002 and 2017,1,677 LT were performed in our institution among which 141(8.4%)with unusable recipient HA were analyzed.Four groups were defined according to the site of anastomosis:the splenic artery(SA group,n=26),coeliac trunk(CT group,n=12),aorta using or not the donor’s vessel(Ao group,n=91)and aorta using a vascular prosthesis(Ao-P group,n=12)as conduit.The median number of intraoperative red blood cell transfusions was significantly increased in the Ao and Ao-P groups(5,5,8.5 and 16 for SA,CT,Ao and Ao-P group respectively,P=0.002),as well as fresh frozen plasma(4.5,2.5,10,17 for the SA,CT,Ao and Ao-P groups respectively,P=0.001).Hospitalization duration was also significantly increased in the Ao and Ao-P groups(15,16,24,26.5 days for the SA,CT,Ao and Ao-P groups respectively,P<0.001).The occurrence of early allograft dysfunction(EAD)(P=0.07)or arterial complications(P=0.26)was not statistically different.Level of factor V,INR,bilirubin and creatinine during the 7th postoperative days(POD)was significantly improved in the SA group.No difference was observed regarding graft(P=0.18)and patient(P=0.16)survival.Conclusions:In case of unusable HA,intraoperative and postoperative outcomes are improved when using the SA or CT compared to aorta. | Jean Marie Beaurepaire Francesco Orlando Giovanni Battista Levi Sandri Caroline Jezequel Edouard Bardou-Jacquet Christophe Camus Mohamed Lakehal Veronique Desfourneaux Aude Merdrignac Elodie Gaignard Alexandre Thobie Damien Bergeat Bernard Meunier Michel Rayar | 2022 | Hepatobiliary Surgery and Nutrition2022，11，1： | 3 |
| 3 | Iron metabolism imbalance at the time of listing increases overall and infectious mortality after liver transplantation显示文摘BACKGROUND Liver transplantation(LT)is the best treatment for patients with liver cancer or end stage cirrhosis,but it is still associated with a significant mortality.Therefore identifying factors associated with mortality could help improve patient management.The impact of iron metabolism,which could be a relevant therapeutic target,yield discrepant results in this setting.Previous studies suggest that increased serum ferritin is associated with higher mortality.Surprisingly iron deficiency which is a well described risk factor in critically ill patients has not been considered.AIM To assess the impact of pre-transplant iron metabolism parameters on posttransplant survival.METHODS From 2001 to 2011,553 patients who underwent LT with iron metabolism parameters available at LT evaluation were included.Data were prospectively recorded at the time of evaluation and at the time of LT regarding donor and recipient.Serum ferritin(SF)and transferrin saturation(TS)were studied as continuous and categorical variable.Cox regression analysis was used to determine mortality risks factors.Follow-up data were obtained from the local and national database regarding causes of death.RESULTS At the end of a 95-mo median follow-up,196 patients were dead,38 of them because of infections.In multivariate analysis,overall mortality was significantly associated with TS>75%[HR:1.73(1.14;2.63)],SF<100μg/L[HR:1.62(1.12;2.35)],hepatocellular carcinoma[HR:1.58(1.15;2.26)],estimated glomerular filtration rate(CKD EPI Cystatin C)[HR:0.99(0.98;0.99)],and packed red blood cell transfusion[HR:1.05(1.03;1.08)].Kaplan Meier curves show that patients with low SF(<100μg/L)or high SF(>400μg/L)have lower survival rates at 36 mo than patients with normal SF(P=0.008 and P=0.016 respectively).Patients with TS higher than 75%had higher mortality at 12 mo(91.4%±1.4%vs 84.6%±3.1%,P=0.039).TS>75%was significantly associated with infection related death[HR:3.06(1.13;8.23)].CONCLUSION Our results show that iron metabolism imbalance(either deficiency or overload)is associated with post-transplant overall and infectious mortality.Impact of iron supplementation or depletion should be assessed in prospective study. | Elodie Fallet Michel Rayar Amandine Landrieux Christophe Camus Pauline Houssel-Debry Caroline Jezequel Ludivine Legros Thomas Uguen Martine Ropert-Bouchet Karim Boudjema Dominique Guyader Edouard Bardou-Jacquet | 2020 | World Journal of Gastroenterology2020，26，16： | 2 |
| 4 | Enteral Nutrition Reduces Delayed Gastric Emptying After Standard Pancreaticoduodenectomy with Child Reconstruction显示文摘 | Michel Rayar Laurent Sulpice Bernard Meunier Karim Boudjema | 2012 | Journal of Gastrointestinal Surgery2012，，5： | 2 |
| 5 | Molecular profiling of stro- ma identifies osteopontin as an independent predictor of poor prognosis in intrahepatic cholangiocarcinoma显示文摘 | Sulpice L Rayar M Desille M | 2013 | Hepatology2013，58，6： | 1 |
| 6 | Epithelial cell adhesion molecule is a prognosis marker for intrahepatic cholangiocarcinoma显示文摘 | Laurent Sulpice Michel Rayar Bruno Turlin Eveline Boucher Pascale Bellaud Mireille Desille Bernard Meunier Bruno Clément Karim Boudjema Cédric Coulouarn | 2014 | Journal of Surgical Research2014，，： | 1 |
| 7 | Enteral nutrition reduces delayed gastric emptying after standard pancreaticoduodenectomy with child reconstruction 显示文摘 | Rayar M Sulpice L Meunier B | 2012 | J Gastrointest Surg2012，16，5： | 1 |
| 8 | Biliary cirrhosis and sepsis are two risk factors of failure after surgical repair of major bile duct injury post-laparoscopic cholecystectomy显示文摘 | Sulpice L Garnier S Rayar M | 2014 | Langenbecks Arch Surg2014，399，5： | 1 |
| 9 | Disease-free survival af- ter simultaneous or delayed resection of synchronous colorectal liver metastasis and primary cancer显示文摘 | Bigourdan JM Faber B Rayar M | 2014 | Hepatogastroenterology2014，61，： | 1 |
| 10 | Treatment of recurrent in- trahepatic cholangiocarcinoma 显示文摘 | Sulpice L Rayar M Boucher E | 2012 | Br J Surg2012，99，12： | 1 |
| 11 | Does an aberrant right hepatic artery really influence the short- and long-term results of a pancreaticoduodenectomy for malignant disease? A matched case-controlled study显示文摘 | L. Sulpice M. Rayar C. Paquet D. Bergeat D. Cunin B. Meunier K. Boudjema | 2013 | Journal of Surgical Research2013，，： | 1 |
| 12 | Enteral nutrition reduces delayed gastric emptying after standard pancreaticoduodenectomy with child reconstruction显示文摘 | Rayar M Sulpice L Meunier B | 2012 | J Gastrointest Surg2012，16，5： | 1 |
| 13 | Enteral nutrition reduces delayed gastric emptying after standard pancreaticoduodenectomy with child reconstruction 显示文摘 | Rayar M Sulpice L Meunier B | 2012 | J Gastrointest Surg2012，16，5： | 1 |
| 14 | Enteral Nutrition Reduces Delayed Gastric Emptying After Standard Pancreaticoduodenectomy with Child Reconstruction显示文摘 | Rayar M Sulpice L Meunier B | 2012 | J Gastrointest Surg2012，16，5： | 1 |
| 15 | Enteral nutrition re- duces delayed gastric emptying after standard pancreaticoduode- nectomy with child reconstruction 显示文摘 | Rayar M Sulpiee L Meunier B | 2012 | J Gastrointest Surg2012，16，5： | 1 |
| 16 | Enteral nutrition reduces delayed gastric emptying after standard pancreaticoduodenectomy with child reconstruction显示文摘 | Rayar M SuIpice L Meunier B | 2012 | J Gastrointest Surg2012，16，5： | 1 |
| 17 | Conservative surgical management of Boerhaave’s syndrome: Experience of two tertiary referral centers显示文摘 | L. Sulpice S. Dileon M. Rayar B. Badic K. Boudjema J.P. Bail B. Meunier | 2012 | International Journal of Surgery2012，，： | 1 |
| 18 | ALPPS procedure forhepatocellular carcinoma with macrovascular thrombosis: a newopportunity-显示文摘 | Levi Sandri GB Lai Q Rayar M | 2015 | J Hepatol2015，62，1： | 1 |
| 19 | ALPPS procedure for hepatocellular carcinoma with macrovascular thrombosis: A new opportunity?显示文摘 | Giovanni Battista Levi Sandri Quirino Lai Michel Rayar Laurent Sulpice | 2014 | Journal of Hepatology2014，，： | 1 |
| 20 | Enteral nutrition re- duces delayed gastric emptying after standard pancreati- coduodenectomy with chil&reconstruction显示文摘 | Rayar M Sulpice L Meunier B | 2012 | J Gastroin- test Surg2012，16，5： | 1 |
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