J L Gaudin

CHU de Lyon - Hôpital de la Croix-Rousse, Lyons, Rhône-Alpes, France

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Publications (18)33.74 Total impact

  • S Cherki · M Adham · T Bizollon · J L Gaudin · J Baulieux
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    ABSTRACT: One case of small bowel's intussuception has been found in one patient with abdominal pains. Since 13 years this patient has a Peutz-Jeghers syndrome. A resection of the small bowel has been performed followed by total intraoperative enteroscopy. Besides small bowel, Peutz-Jeghers syndrome can affect many organs with an increased risk for cancer for patients affected by this genetic disease.
    No preview · Article · Dec 2002 · Annales de Chirurgie
  • S Cherki · M Adham · T Bizollon · J.-L Gaudin · J Baulieux
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    ABSTRACT: One case of small bowel’s intussuception has been found in one patient with abdominal pains. Since 13 years this patient has a Peutz-Jeghers syndrome. A resection of the small bowel has been performed followed by total intraoperative enteroscopy. Besides small bowel, Peutz-Jeghers syndrome can affect many organs with an increased risk for cancer for patients affected by this genetic desease.
    No preview · Article · Sep 2002 · Annales de Chirurgie
  • S. El Khaddari · J.-L. Gaudin · H. Abidi · G. Picaud · A. Rode · J.-C. Souquet
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    ABSTRACT: Aim - The aim of the study was to determine whether simple routine parameters evaluating the first session of transarterial chemoembolization (variation in alfa-fetoprotein concentration, tumor lipiodol uptake, and post-embolization syndrome) can predict survival of patients treated for hepatocellular carcinoma. Methods - Seventy-two patients treated with transarterial chemoembolization and evaluated one month after the first sessions with CT scan were included. Transarterial chemoembolization session included hepatic arteriography, lipiodol and doxorubicin (50 mg) emulsion injection, followed by gelatin sponge embolization. The following variables were studied in univariate and multivariate analysis: 6 recorded at the first session (age, cirrhosis etiology, Child-Pugh class, tumor number, largest lesion size, and alpha-fetoprotein concentration), and 5 recorded after the first session (variation in alfa-fetoprotein concentration, tumor lipiodol uptake, post-embolization syndrome, mean interval between each session, and associated treatment). Results - Mean follow-up was 22.7 months (4-106). Mean survival was 30.4 months (95% CI: 23.3-37.5). Actuarial survival at 1, 2, 3 and 5years was respectively 65.5%, 44%, 29. 5%, and 18%. The only independent prognostic factors in multivariate analysis were the Child Pugh class and the mean interval between sessions (P < 0.001 and < 0.01 respectively). None of our criteria evaluating the first TACE session significantly influenced survival. Conclusion - The 3 parameters (variation in alfa-fetoprotein concentration, tumor lipiodol uptake and post-embolization syndrome) after the first transarterial chemoembolization did not predict survival. They could not be used to determine which patient could benefit from repeated transarterial chemoembolization sessions.
    No preview · Article · Aug 2002
  • S. Cherki · M. Adham · T. Bizollon · J. Gaudin · J. Baulieux

    No preview · Article · Jan 2002 · Annales de Chirurgie
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    ABSTRACT: The purpose of this work was to evaluate the detection and characterization of nodules > or = 8 mm and small hepatocellular carcinomas (HCCs) in liver cirrhosis. Pathologic examination and results of US, helical CT, and dynamic MRI with gadolinium were compared after orthotopic liver transplantation (OLT) of 43 cirrhotic patients. Nodules were classified as macroregenerative nodules (MRNs), borderline nodules (BNs), and HCC. Pathologic examination classified 69 nodules: 50 MRNs, 6 BNs, and 13 HCCs. Sensitivities of MRN, BN, and HCC detection were, respectively, for US imaging 2% (1/50), 33.3% (2/6), and 46.2% (6/13); for helical CT 2% (1/50), 50% (3/6), and 53.8% (7/13); and for MRI 42% (21/50), 50% (3/6), and 76.9% (10/13). MRI detected 21 MRNs. They presented on T1/T2-weighted images as hyperintense/hypointense (n = 8), hyperintense/isointense (n = 7), hypointense/hypointense (n = 4), hypointense/isointense (n = 1), and hypointense depicted only on echo planar imaging (n = 1). The three detected BNs were hyperintense/hypointense nodules. The 10 detected HCCs appeared hyperintense/isointense (n = 7), hyperintense/hypointense (n = 2), and hypointense/isointense (n = 1). None of the MRNs but eight HCCs and one BN were enhanced after gadolinium injection. Contrast-enhanced MRI is the most sensitive technique for detecting liver nodules. No MR signal intensity pattern characteristic of small HCCs enables differentiation from benign nodules, however. Gadolinium enhancement is the most sensitive and specific characteristic of HCC.
    No preview · Article · Apr 2001 · Journal of Computer Assisted Tomography
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    ABSTRACT: The aim of this prospective, randomized, study performed in 60 outpatients was to compare 2 precolonoscopy bowel preparations: oral sodium phosphate (NaP) versus standard polyethylene glycol-based lavage solution (PEG). None of the patients met any of NaP exclusion criteria. All patients were prepared on the day prior to colonoscopy. A patient-questionnaire and measure of serum electrolytes (calcium, phosphate, sodium, potassium), pulse and blood pressure were used to assess tolerance and acceptability of the preparation. The quality of colon cleansing was judged by blinded endoscopists. Patient's tolerance to NaP was superior to PEG: NaP preparation was easier to drink and feelings of abdominal plenitude occurred in a smaller proportion of patients. A potassium decrease, a sodium increase and hyperphosphatemia were observed in the NaP group but without clinical events. PEG preparation seemed to allow a better cleansing ability compared with NaP but this difference was not statistically significant. NaP solution was better tolerated and accepted by patients. Colonic preparation quality compared to PEG is still to be discussed depending on the intake schedule. A biochemical data check seems necessary on account of significant serum electrolytes changes induced by NaP preparation.
    No preview · Article · Feb 2001 · Gastroentérologie Clinique et Biologique
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    ABSTRACT: The aim of this study was to report the results of a retrospective series of 26 patients with Barrett's esophagus treated by antireflux surgery. From 1979 to 1998, 21 men and five women (mean age: 53 years) with histologically proven Barrett's esophagus underwent an antireflux procedure. The mean length of Barrett's epithelium was 5.9 cm for 19 patients (73.1%). Six patients (23.1%) had tongue lesions of Barrett's epithelium, and one (3.8%) had ectopic gastric mucosa. None of the patients had a preoperative esophageal biopsy that revealed high-grade dysplasia or carcinoma. Laparotomy was performed in 17 cases and laparoscopy in nine cases. Preoperative endoscopic local treatment with argon coagulation was performed in one patient. Clinical mean follow-up was 78 months and endoscopic mean follow-up was 59.3 months. No increase in the length of the Barrett's epithelium was observed. Seven patients (27%) had complete or partial regression (among them three patients with tongue lesions and one patient preoperatively treated by argon). No patients developed high-grade dysplasia or carcinoma. Regression of Barrett's esophagus is possible but not frequent and unpredictable after antireflux procedure. However, endoscopic and histological surveillance should be continued postoperatively.
    No preview · Article · Oct 1999 · Chirurgie
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    ABSTRACT: Study aimThe aim of this study was to report the results of a retrospective series of 26 patients with Barrett's esophagus treated by antireflux surgery.Patients and methodsFrom 1979 to 1998, 21 men and five women (mean age: 53 years) with histologically proven Barrett's esophagus underwent an antireflux procedure. The mean length of Barrett's epithelium was 5.9 cm for 19 patients (73.1%).Six patients (23.1%) had tongue lesions of Barrett's epithelium, and one (3.8%) had ectopic gastric mucosa. None of the patients had a preoperative esophageal biopsy that revealed high-grade dysplasia or carcinoma. Laparotomy was performed in 17 cases and laparoscopy in nine cases. Preoperative endoscopic local treatment with argon coagulation was performed in one patient.ResultsClinical mean follow-up was 78 months and endoscopic mean follow-up was 59.3 months. No increase in the length of the Barrett's epithelium was observed. Seven patients (27%) had complete or partial regression (among them three patients with tongue lesions and one patient preoperatively treated by argon). No patients developed high-grade dysplasia or carcinoma.ConclusionRegression of Barrett's esophagus is possible but not frequent and unpredictable after antireflux procedure. However, endoscopic and histological surveillance should be continued postoperatively.
    No preview · Article · Sep 1999 · Chirurgie
  • E Vaillant · J L Gaudin · R Bobichon · J C Souquet

    No preview · Article · Dec 1998 · Gastroentérologie Clinique et Biologique
  • JL Gaudin · A Hot · O Dumont · R Bobichon · JC Souquet

    No preview · Article · Apr 1998 · Gastroenterology

  • No preview · Article · Apr 1998 · Endoscopy
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    ABSTRACT: Push enteroscopy is nowadays the recommended technic for the exploration of the upper small intestine. Limited data have been given concerning the examination of the lower small intestine. The aim of this retrospective study was to determine the feasibility and diagnostic contribution of push enteroscopy for the retrograde exploration of the ileum. Patients and methods: From July 96 to August 97, 22 push enteroscopies were performed for the exploration of the ileum. There were 14 female and 8 male, mean age 49yr (15-84). Previous right colectomy have been performed in 2 patients. Examinations were performed under general anesthesia with an Olympus SIF 100 video enteroscope after colonic cleaning (PEG solution). A stiffener was used under scopic control. Indications were the following: microcytic anemia (n=6) or unexplained heamorrhage (n=3) with normal gastroscopy, colonoscopy, barium study of the small intestine, and upper push enteroscopy; possible disease of the ileum (n=9); various (n=4). Results: Enteroscopy was not possible in 5 cases (tight stenosis of the ileocaecal junction confirmed by surgery, n=4; impossibility to enter the ileum, n=1). In the 17 other cases, the estimated mean of the ileum explored was 50 cm (5-90 cm). Only one minor complication was observed (pneumopathy). For patients with digestive bleeding, enteroscopy was useful in only one case, by discovering a Crohn's disease of the ileum. For patients with possible ileal diseases, enteroscopy confirmed Crohn's disease in 3 cases, showed a carcinoid tumor in 1 case, was normal in one case while the barium study was abnormal. In the last heterogenous group, enteroscopy defined the extension of Crohn's disease before surgery (colectomy) in one case and removed a foreign body in another case. Conclusions: Exploration of the ileum by push enteroscopy, while feasible, was sometimes technically difficult. Usefulness was limited in case of unexplained digestive bleeding. It was greater when a localized disease of the ileum was suspected by the barium study of the small intestine.
    No preview · Article · Jan 1998
  • F Romand · J L Gaudin · R Bobichon · J C Souquet
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    ABSTRACT: Abdominal tuberculosis is rarely encountered in developed countries, representing less than 1% of all forms of tuberculosis. There has however been a revival over the last few years. The initial diagnoses suspected in two young multiparous patients who had immigrated to France were malignant lymphoma and ovarian carcinoma. After the final diagnosis of abdominal tuberculosis was made, the clinical course rapidly improved. Any abdominal organ may be involved in this localization of tuberculosis, but symptoms are not specific and diagnosis can often be missed. Tumor-forming abdominal mass is an exceptional finding and often mimics malignancy. Clinicians should be aware of this localization, particularly in light of epidemiological features, and examine all modern diagnostic procedures.
    No preview · Article · Dec 1997 · La Presse Médicale
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    ABSTRACT: The aim of this study was to assess the feasibility and efficacy of transjugular intrahepatic portosystemic shunts for refractory variceal bleeding, uncontrolled by sclerotherapy or endoscopic ligation. 11 patients (mean age: 52 years) with cirrhosis admitted for refractory haemorrhage from ruptured oesophageal varices were included in this study. Eight patients were Child-Pugh class C. All patients were actively bleeding. All the procedures were successful. Variceal haemorrhage stopped within 24 h. There was no mortality during the procedure. Early complications such as rebleeding (18%) and thrombosis (18%) occurred. Thirty days mortality was 27%. Follow-up in the 8 surviving patients was 19.5 +/- 8 months. Three patients developed recurrent bleeding, from non-variceal sources in 2. In 4 surviving patients, occlusion of the shunt was treated with dilatation or insertion of a second stent. The incidence of hepatic encephalopathy was 25%. Five patients subsequently underwent liver transplantation. Among the 3 patients ineligible for transplantation, one died of hepatocellular carcinoma after 10 months. The 2 others were alive after 19 and 25 months, respectively. These results suggest that transjugular intrahepatic portosystemic shunt is a safe and effective procedure of portal decompression in patients with refractory variceal bleeding. Prospective trials comparing this percutaneous procedure and surgical treatment are required.
    No preview · Article · Dec 1995 · Gastroentérologie Clinique et Biologique
  • T Bizollon · J L Gaudin · P Jacob · B Bouvet · M Evreux · J C Souquet · C Trépo
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    ABSTRACT: The aim of this study was to assess the morbidity and efficacy of endoscopic variceal ligation for the prophylaxis of rebleeding from oesophageal varices. Forty-five patients with cirrhosis (Child's class: A: 18, B: 16, C: 11) and recent (< 48 h) variceal bleeding were included. Eleven of the patients were included after failure of sclerotherapy. All patients were treated by endoscopic ligation until the complete eradication of oesophageal varices. The mean follow-up was 8.7 +/- 6.8 months. Oesophageal varices were eradicated in 40 patients (89%) after an average of 2 sessions (range: 1-5). In a subset of 11 patients treated after failure of sclerotherapy, 8 (73%) had complete eradication of oesophageal varices. Six of the 45 patients (13%) had recurrence of haemorrhage, due to post-ligation ulcerations in 5 cases and to rupture of oesophageal varices in one case. The rate of complications was 7%. Of the 40 patients whose oesophageal varices were eradicated, 7 (17%) were lost for follow up, and another treatment was performed in 4 (10%): liver transplantation in 2, and transjugular intrahepatic portosystemic shunt in 2. Recurrence of oesophageal varices after eradication was observed in 3 (10%) of the remaining 29 patients after a follow-up of 8.9 +/- 12.9 months. Of these 3 patients, only one (3%) presented with recurrence of haemorrhage due to ruptured oesophageal varices. Three patients (7%) died before eradication of oesophageal varices from causes unrelated to the technique. This study confirms that endoscopic ligation is effective for eradication of oesophageal varices, with a low morbidity. This technique appears to be a method of choice in the prophylaxis of rebleeding from oesophageal varices, especially when sclerotherapy is ineffective.
    No preview · Article · Nov 1995 · Gastroentérologie Clinique et Biologique
  • J L Gaudin · J Dumortier · J C Souquet · A Bel

    No preview · Article · Jul 1994 · La Presse Médicale
  • J L Gaudin · M Vallas · G Genin · J C Souquet · A Bel

    No preview · Article · Feb 1993 · Gastroentérologie Clinique et Biologique
  • J L Gaudin · B Bancel · T Vial · A Bel

    No preview · Article · Feb 1993 · Gastroentérologie Clinique et Biologique
  • J.-L. Gaudin · M. Vallas · G. Genin · J.-C. Souquet · A. Bel

    No preview · Article · Jan 1993