Charles Henri Julio

Publications (2)4.72 Total impact

• Article: Spleen-preserving distal pancreatectomy with excision of splenic artery and vein: a case-matched comparison with conventional distal pancreatectomy with splenectomy.

  Nicolas Carrère, Skander Abid, Charles Henri Julio, Eric Bloom, Bernard Pradère
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  ABSTRACT: The value of spleen preservation during distal pancreatectomy (DP) still remains controversial. Spleen-preserving DP with excision of the splenic artery and vein is a simplified technique for spleen preservation. The aim of this study was to compare the postoperative course of DP with or without splenectomy. From 1990 to 2005, 38 consecutive patients with benign or low-grade malignant disease underwent a spleen-preserving DP operation with excision of the splenic artery and vein (Conservative Group). They were compared with 38 patients who underwent conventional DP with splenectomy over the same time period (Splenectomy Group) and who had been matched for age, American Society of Anesthesiologists (ASA) score, and pathological diagnosis. Postoperative courses were analyzed and compared between the Conservative Group and Splenectomy Group. Spleen preservation was effective in 36 of the 38 attempts (95%). Postoperative complications - in particular, infectious intra-abdominal complications - were significantly higher in the Splenectomy Group (34 and 18%, respectively) than in the Conservative Group (13 and 3%, respectively) (P = 0.03 and P = 0.02, respectively). The length of the surgery, perioperative blood loss or transfusions, perioperative mortality and length of hospital stay did not differ between the two groups. Univariate analysis showed that splenectomy was the only risk factor for postoperative complication. Spleen-preserving DP with excision of the splenic artery and vein is a fast, safe and effective procedure associated, in this series, with a reduction of postoperative complications relative to conventional DP with splenectomy. This technique should be considered in patients with benign or low-grade malignant disease of the pancreas.
  World Journal of Surgery 03/2007; 31(2):375-82. · 2.36 Impact Factor
• Article: Is nasogastric or nasojejunal decompression necessary after gastrectomy? A prospective randomized trial.

  Nicolas Carrère, Patrick Seulin, Charles Henri Julio, Eric Bloom, Jean-Luc Gouzi, Bernard Pradère
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  ABSTRACT: Nasogastric decompression has been routinely used in most major abdominal operations to prevent the consequences of postoperative ileus. The aim of the present study was to assess the necessity for routine prophylactic nasogastric or nasojejunal decompression after gastrectomy. A prospective randomized trial included 84 patients undergoing elective partial or total gastrectomy. The patients were randomized to a group with a postoperative nasogastric or nasojejunal tube (Tube Group, n = 43) or to a group without a tube (No-tube Group, n = 41). Gastrointestinal function, postoperative course, and complications were assessed. No significant differences in postoperative mortality or morbidity, especially fistula or intra-abdominal sepsis, were observed between the groups. Passage of flatus (P < 0.01) and start of oral intake (P < 0.01) were significantly delayed in the Tube Group. Duration of postoperative perfusion (P = 0.02) and length of hospital stay (P = 0.03) were also significantly longer in the Tube Group. Rates of nausea and vomiting were similar in the two groups. Moderate to severe discomfort caused by the tube was observed in 72% of patients in the Tube Group. Insertion of a nasogastric or nasojejunal tube was necessary in 5 patients in the No-tube Group (12%). Routine prophylactic postoperative nasogastric decompression is unnecessary after elective gastrectomy.
  World Journal of Surgery 01/2007; 31(1):122-7. · 2.36 Impact Factor