1
|
Saumtally MS, Trigui A, Akrout A, Boujelben S. Silent portobiliary fistula. Cir Esp 2024:S2173-5077(24)00098-X. [PMID: 38642802 DOI: 10.1016/j.cireng.2024.01.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Accepted: 01/28/2024] [Indexed: 04/22/2024]
Affiliation(s)
- Mohammad Saad Saumtally
- University of Sfax, Faculty of Medicine, Department of Urology, Habib Bourguiba Hospital, Sfax, Tunisia.
| | - Aymen Trigui
- University of Sfax, Faculty of Medicine, Department of General and Digestive Surgery, Habib Bourguiba Hospital, Sfax, Tunisia
| | - Amira Akrout
- University of Sfax, Faculty of Medicine, Department of General and Digestive Surgery, Habib Bourguiba Hospital, Sfax, Tunisia
| | - Salah Boujelben
- University of Sfax, Faculty of Medicine, Department of General and Digestive Surgery, Habib Bourguiba Hospital, Sfax, Tunisia
| |
Collapse
|
2
|
Trigui A, Toumi N, Fendri S, Saumtally MS, Zribi I, Akrout A, Mzali R, Ketata S, Dziri C, Amar MB, Boujelbene S. Cystic Echinococcosis of the Liver: Correlation Between Intra-Operative Ultrasound and Pre-Operative Imaging. Surg Infect (Larchmt) 2024; 25:213-220. [PMID: 38483340 DOI: 10.1089/sur.2023.335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/10/2024] Open
Abstract
Background: Imaging plays an essential role in the management of hepatic hydatid cysts (HCE). The objective of our study was to determine the correlation between pre-operative ultrasound, computed tomography (CT), and intra-operative ultrasound (IOUS) in studying the characteristics and complications of HCE. Patients and Methods: This was a prospective, descriptive, and analytical study conducted in the General Surgery Department of Habib Bourguiba Hospital in Sfax. The study included patients with HCE who underwent conservative surgery between April 2017 and June 2022. Results: We enrolled 49 patients with 94 cysts. At the end of our study, IOUS allowed for better detection of HCE (98.8%) regardless of the number of cysts per patient. IOUS and CT were accurate in studying the location of cysts (κ = 1), whereas pre-operative abdominal ultrasound was less efficient (κ = 0.870). IOUS was the best examination for detecting exocysts (κ = 0.961), studying daughter cysts (κ = 0.823), and exploring vascular relations, but it was less effective (κ = 0.523) in detecting calcifications. Regarding classifications, ultrasound and CT had similar results. However, IOUS was most reliable in differentiating between CE3b and CE4 types (κ = 0.653). Ultrasound, CT, and IOUS were not sensitive in detecting latent HCE suppurations and cystobiliary fistulas. Conclusions: Performing IOUS is essential to prevent recurrences and reduce post-operative morbidity.
Collapse
Affiliation(s)
- Aymen Trigui
- Department of General and Digestive Surgery, Habib Bourguiba Hospital, Faculty of Medicine, University of Sfax, Sfax, Tunisia
| | - Nozha Toumi
- Department of Radiology, Habib Bourguiba Hospital, Faculty of Medicine, University of Sfax, Sfax, Tunisia
| | - Sami Fendri
- Department of General and Digestive Surgery, Habib Bourguiba Hospital, Faculty of Medicine, University of Sfax, Sfax, Tunisia
| | - Mohammad Saad Saumtally
- Department of General and Digestive Surgery, Habib Bourguiba Hospital, Faculty of Medicine, University of Sfax, Sfax, Tunisia
| | - Imen Zribi
- Department of General and Digestive Surgery, Hopital Regional Mahres, Faculty of Medicine, University of Sfax, Sfax, Tunisia
| | - Amira Akrout
- Department of General and Digestive Surgery, Habib Bourguiba Hospital, Faculty of Medicine, University of Sfax, Sfax, Tunisia
| | - Rafik Mzali
- Department of General and Digestive Surgery, Habib Bourguiba Hospital, Faculty of Medicine, University of Sfax, Sfax, Tunisia
| | - Salma Ketata
- Department of Anesthesiology, Habib Bourguiba Hospital, Faculty of Medicine, University of Sfax, Sfax, Tunisia
| | - Chadli Dziri
- University of Tunis El Manar, General Surgery; Honoris Medical Simulation Center, Tunisia
| | - Mohamed Ben Amar
- Department of General and Digestive Surgery, Habib Bourguiba Hospital, Faculty of Medicine, University of Sfax, Sfax, Tunisia
| | - Salah Boujelbene
- Department of General and Digestive Surgery, Habib Bourguiba Hospital, Faculty of Medicine, University of Sfax, Sfax, Tunisia
| |
Collapse
|
3
|
Trigui A, Fendri S, Akrout A, Trabelsi J, Daoud R, Saumtally MS, Ketata S, Baklouti S, Boujelbene W, Mzali R, Dziri C, Rejab H, Boujelbene S. Predictive factors of occult cystobiliary fistulas during conservative treatment of hepatic hydatid cyst: a prospective study. J Gastrointest Surg 2024; 28:108-114. [PMID: 38445931 DOI: 10.1016/j.gassur.2023.11.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Revised: 10/04/2023] [Accepted: 10/14/2023] [Indexed: 03/07/2024]
Abstract
BACKGROUND Occult cystobiliary fistula (CBF) is a common complication of hepatic hydatid cyst (HHC). It is often the cause of high morbidity of conservative treatment of HHC. This study aimed to determine the predictive factors of occult CBF to establish the indications for the investigation and treatment of these CBFs. METHODS This was a prospective study that included all operated HHCs over a 3-year period. HHCs complicated with large CBFs were not included in the study. Systematic cholecystectomy and methylene blue test for all cysts were performed. RESULTS A total of 46 patients operated on with 113 cysts were included in this study. The median cyst size was 6.7 cm (IQR, 1-38). A total of 114 CBFs were detected in 51 cysts (45.1%). The postoperative course was simple in 95.0% of cases. The specific morbidity rate was 2.7%. In a bivariate study, absence of mass and abdominal pain on palpation, hemoglobin level >11.55 g/dL, negative hydatid serology, cyst size, absence of calcifications, vascular compression, existence of a single cyst, and localization at segment VIII were predictive factors of occult CBF. At the end of the multivariate study, cyst size was determined to be the only predictive factor for occult CBF. A threshold of 3 cm was used. CONCLUSION Cyst size is a major predictive factor for occult CBF.
Collapse
Affiliation(s)
- Aymen Trigui
- Department of General and Digestive Surgery, Faculty of Medicine, Habib Bourguiba Hospital, University of Sfax, Sfax, Tunisia.
| | - Sami Fendri
- Department of General and Digestive Surgery, Faculty of Medicine, Habib Bourguiba Hospital, University of Sfax, Sfax, Tunisia
| | - Amira Akrout
- Department of General and Digestive Surgery, Faculty of Medicine, Habib Bourguiba Hospital, University of Sfax, Sfax, Tunisia
| | - Jihen Trabelsi
- Department of Epidemiology, Faculty of Medicine, Hedi Cheker Hospital, University of Sfax, Sfax, Tunisia
| | - Rahma Daoud
- Department of General and Digestive Surgery, Faculty of Medicine, Habib Bourguiba Hospital, University of Sfax, Sfax, Tunisia
| | - Mohamed Saad Saumtally
- Department of General and Digestive Surgery, Faculty of Medicine, Habib Bourguiba Hospital, University of Sfax, Sfax, Tunisia
| | - Salma Ketata
- Department of Anesthesiology, Faculty of Medicine, Habib Bourguiba Hospital, University of Sfax, Sfax, Tunisia
| | - Soulaymen Baklouti
- Department of General and Digestive Surgery, Faculty of Medicine, Habib Bourguiba Hospital, University of Sfax, Sfax, Tunisia
| | - Wael Boujelbene
- Department of General and Digestive Surgery, Faculty of Medicine, Habib Bourguiba Hospital, University of Sfax, Sfax, Tunisia
| | - Rafik Mzali
- Department of General and Digestive Surgery, Faculty of Medicine, Habib Bourguiba Hospital, University of Sfax, Sfax, Tunisia
| | - Chadli Dziri
- Department of General Surgery, Medical School of Tunis, University of Tunis El Manar, Tunis, Tunisia; Honoris Medical Simulation Center, Tunis, Tunisia
| | - Haithem Rejab
- Department of General and Digestive Surgery, Faculty of Medicine, Habib Bourguiba Hospital, University of Sfax, Sfax, Tunisia
| | - Salah Boujelbene
- Department of General and Digestive Surgery, Faculty of Medicine, Habib Bourguiba Hospital, University of Sfax, Sfax, Tunisia
| |
Collapse
|
4
|
Trigui A, Khmekhem N, Fendri S, Daoud R, Akrout A, Trabelsi J, Mzali R, Cheikhrouhou F, Ayadi A, Dziri C, Amar MB, Boujelbene S. Viability predictive factors of the daughter vesicles in hepatic cystic echinococcosis. BMC Infect Dis 2024; 24:43. [PMID: 38172702 PMCID: PMC10765707 DOI: 10.1186/s12879-023-08937-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 12/19/2023] [Indexed: 01/05/2024] Open
Abstract
INTRODUCTION Management of cystic echinococcosis (CE) requires knowledge of certain aspects related to the survival of Echinococcus granulosus. The viability of daughter vesicles (DV) is a determining factor in guiding therapeutic indications, particularly for transiently active Cysts type CE3b. PURPOSE To determine the predictive factors of DV viability and its impact on the therapeutic management of CE3b type. MATERIALS AND METHODS This is a prospective pilot study with an analytical aim on patients with cystic echinococcosis of the liver type CE2 and CE3b, operated in the General Surgery Department of Habib-Bourguiba Academic Hospital, Sfax-Tunisia for 22 months from March 2018 until December 2019. The unit of the study is the DV. A parasitological study of the DV was done in the parasitology laboratory. RESULTS During the study period, 27 (40.9%) of 66 operated CE Disease from 21 patients containing 248 DV were explored. The median viability of DV protoscoleces was 16.7%. In bivariate analysis, factors for viability of DV protoscoleces were: fever, acute cholangitis, hyperbilirubinemia, left liver location, rock water and bilious echinococcal fluid (EF), cyst size ≥ 43 mm, Intracystic pressure ≥ 35 mmHg, DV size ≥ 6.5 mm, volume, number of DV/cyst ≥ 5, and opaque wall (p < 0.05). Predictive factors for the Non-viability of DV were: CE3b type, purulent EF, gelatinous EF. In multivariate analysis, only CE2 type, cyst size ≥ 43 mm, number of DV/cyst ≥ 5 and DV size ≥ 6.5 mm were factors significantly associated with the viability of DV protoscoleces. CONCLUSION CE3b cysts without the criteria of viability of DV protoscoleces may become candidates for the 'Wait-and-Watch' procedure.
Collapse
Affiliation(s)
- Aymen Trigui
- Faculty of Medicine, Department of General and Digestive Surgery, University of Sfax, Habib Bourguiba Hospital, Sfax, 3029, Tunisia.
| | - Nahed Khmekhem
- Faculty of Medicine, Department of Parasitology and Mycology, University of Sfax, Habib Bourguiba Hospital, Sfax, Tunisia
| | - Sami Fendri
- Faculty of Medicine, Department of General and Digestive Surgery, University of Sfax, Habib Bourguiba Hospital, Sfax, 3029, Tunisia
| | - Rahma Daoud
- Faculty of Medicine, Department of General and Digestive Surgery, University of Sfax, Habib Bourguiba Hospital, Sfax, 3029, Tunisia
| | - Amira Akrout
- Faculty of Medicine, Department of General and Digestive Surgery, University of Sfax, Habib Bourguiba Hospital, Sfax, 3029, Tunisia
| | - Jihene Trabelsi
- Faculty of Medicine, Department of Epidemiology, University of Sfax, Hedi Cheker Hospital, Sfax, Tunisia
| | - Rafik Mzali
- Faculty of Medicine, Department of General and Digestive Surgery, University of Sfax, Habib Bourguiba Hospital, Sfax, 3029, Tunisia
| | - Fatma Cheikhrouhou
- Faculty of Medicine, Department of Parasitology and Mycology, University of Sfax, Habib Bourguiba Hospital, Sfax, Tunisia
| | - Ali Ayadi
- Faculty of Medicine, Department of Parasitology and Mycology, University of Sfax, Habib Bourguiba Hospital, Sfax, Tunisia
| | - Chadli Dziri
- General Surgery, Honoris Medical Simulation Center Director, Medical school of Tunis, University El Manar, Tunis, Tunisia
| | - Mohamed Ben Amar
- Faculty of Medicine, Department of General and Digestive Surgery, University of Sfax, Habib Bourguiba Hospital, Sfax, 3029, Tunisia
| | - Saleh Boujelbene
- Faculty of Medicine, Department of General and Digestive Surgery, University of Sfax, Habib Bourguiba Hospital, Sfax, 3029, Tunisia
| |
Collapse
|
5
|
Daoud R, Tlili A, Fendri S, Akrout A, Trigui A, Boujelbene S. Gastric trichobezoar: An uncommon cause of epigastric pain: A case report. Clin Case Rep 2022; 10:e05653. [PMID: 35387286 PMCID: PMC8978792 DOI: 10.1002/ccr3.5653] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 03/13/2022] [Accepted: 03/14/2022] [Indexed: 12/16/2022] Open
Abstract
Trichobezoars are foreign and indigestible materials in the gastrointestinal tract and are usually found in psychiatric females, who often deny eating their own hair, but also at situations of gastric dysmotility and prior gastric surgery. Although rare, gastric trichobezoar should not be forgotten as a differential diagnosis in females presenting with vague epigastric pain. Its treatment well in time will prevent complications.
Collapse
Affiliation(s)
- Rahma Daoud
- Faculty of Medicine of Sfax University of Sfax Sfax Tunisia
- Departement of Surgery Habib Bourguiba Hospital Sfax Tunisia
| | - Ahmed Tlili
- Faculty of Medicine of Sfax University of Sfax Sfax Tunisia
- Departement of Surgery University Hospital Gabes Tunisia
| | - Sami Fendri
- Faculty of Medicine of Sfax University of Sfax Sfax Tunisia
- Departement of Surgery Habib Bourguiba Hospital Sfax Tunisia
| | - Amira Akrout
- Faculty of Medicine of Sfax University of Sfax Sfax Tunisia
- Departement of Surgery Habib Bourguiba Hospital Sfax Tunisia
| | - Aymen Trigui
- Faculty of Medicine of Sfax University of Sfax Sfax Tunisia
- Departement of Surgery Habib Bourguiba Hospital Sfax Tunisia
| | - Salah Boujelbene
- Faculty of Medicine of Sfax University of Sfax Sfax Tunisia
- Departement of Surgery Habib Bourguiba Hospital Sfax Tunisia
| |
Collapse
|
6
|
Trigui A, Rejab H, Akrout A, Trabelsi J, Zouari A, Majdoub Y, Amar MB, Mzali R. Laser utility in the treatment of hemorrhoidal pathology: a review of literature. Lasers Med Sci 2021; 37:693-699. [PMID: 34331606 DOI: 10.1007/s10103-021-03333-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 05/03/2021] [Indexed: 10/20/2022]
Abstract
Hemorrhoidal disease is a common reason for consultation in proctology. It can be treated in several ways (medical, endoscopic, and surgical). Laser treatment has been described since 1960 and has developed in recent years. The purpose of this literature review was to study the results of laser treatment of hemorrhoids and to compare them with those of surgical methods. We performed a systematic search of the literature by querying the Medline, Google Scholar, and Cochrane Library databases. Retrospective studies and case reports were excluded. We selected 11 studies both techniques HeLP (hemorrhoid laser procedure) and LHP (laser hemorrhoidoplasty procedure). The total number of patients was 1179 including 1059 patients treated with laser and 120 treated surgically within the context of comparative studies. The age of the patients varies between 18 and 74 years old. HeLP laser treatment was significantly superior to surgical treatment in terms of postoperative pain (p < 0.001), hemorrhoidal disease downgrading (p < 0.001), and postoperative satisfaction (p < 0.001). Similarly, LHP laser treatment was significantly superior to surgical treatment in terms of operative duration (p < 0.00001), intraoperative bleeding (p < 0.00001), postoperative pain at H12 and H24 (p < 0.00001 and p = 0.0003), and postoperative bleeding rate (p < 0.001). The laser represents a revolution in the field of proctology mainly in the treatment of hemorrhoidal pathology. It is a safe, effective, and less painful mini-invasive technique. More rigorous studies will be needed to better evaluate this technique.
Collapse
Affiliation(s)
- Aymen Trigui
- Department of General and Digestive Surgery, Habib Bourguiba Hospital, Faculty of Medicine, University of Sfax, 3029, Sfax, Tunisia.
| | - Haithem Rejab
- Department of General and Digestive Surgery, Habib Bourguiba Hospital, Faculty of Medicine, University of Sfax, 3029, Sfax, Tunisia
| | - Amira Akrout
- Department of General and Digestive Surgery, Habib Bourguiba Hospital, Faculty of Medicine, University of Sfax, 3029, Sfax, Tunisia
| | - Jihen Trabelsi
- Department of Epidemiology, Hedi Cheker Hospital, Faculty of Medicine, University of Sfax, Sfax, Tunisia
| | - Amine Zouari
- Department of General and Digestive Surgery, Habib Bourguiba Hospital, Faculty of Medicine, University of Sfax, 3029, Sfax, Tunisia
| | - Youssef Majdoub
- Department of General and Digestive Surgery, Habib Bourguiba Hospital, Faculty of Medicine, University of Sfax, 3029, Sfax, Tunisia
| | - Mohamed Ben Amar
- Department of General and Digestive Surgery, Habib Bourguiba Hospital, Faculty of Medicine, University of Sfax, 3029, Sfax, Tunisia
| | - Rafik Mzali
- Department of General and Digestive Surgery, Habib Bourguiba Hospital, Faculty of Medicine, University of Sfax, 3029, Sfax, Tunisia
| |
Collapse
|
7
|
Kardoun N, Hadrich Z, Akrout A, Harbi H, Boujelben S, Mzali R. Tailgut cyst: 2 case reports. Clin Case Rep 2021; 9:e04490. [PMID: 34295496 PMCID: PMC8283855 DOI: 10.1002/ccr3.4490] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 06/02/2021] [Accepted: 06/03/2021] [Indexed: 02/02/2023] Open
Abstract
Tailgut cysts, or retrorectal cystic hamartomas, are rare congenital developmental lesions. It is a benign lesion, but there is a risk of degeneration, so surgical resection is necessary.
Collapse
Affiliation(s)
- Nizar Kardoun
- Departement of SurgeryHabib Bourguiba HospitalSfaxTunisia
- Faculty of Médecine of SfaxSfaxTunisia
| | - Zied Hadrich
- Departement of SurgeryHabib Bourguiba HospitalSfaxTunisia
- Faculty of Médecine of SfaxSfaxTunisia
| | - Amira Akrout
- Departement of SurgeryHabib Bourguiba HospitalSfaxTunisia
- Faculty of Médecine of SfaxSfaxTunisia
| | - Houssem Harbi
- Departement of SurgeryHabib Bourguiba HospitalSfaxTunisia
- Faculty of Médecine of SfaxSfaxTunisia
| | - Salah Boujelben
- Departement of SurgeryHabib Bourguiba HospitalSfaxTunisia
- Faculty of Médecine of SfaxSfaxTunisia
| | - Rafik Mzali
- Departement of SurgeryHabib Bourguiba HospitalSfaxTunisia
- Faculty of Médecine of SfaxSfaxTunisia
| |
Collapse
|
8
|
Rejab H, Trigui A, Ameur HB, Majdoub Y, Daoud R, Akrout A, Boujelbene S, Mzali R. [Hemocholecyst complicated by rupture of the gallbladder]. Pan Afr Med J 2019; 34:45. [PMID: 31762912 PMCID: PMC6859024 DOI: 10.11604/pamj.2019.34.45.18682] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Accepted: 07/30/2019] [Indexed: 11/23/2022] Open
Abstract
L'hémocholécyste est défini par la présence d'une hémorragie au sein de la vésicule biliaire. C'est une complication rare des traitements anticoagulants, elle peut évoluer vers la rupture spontanée de la vésicule biliaire se traduisant par un état de choc hémorragique. Nous rapportons le cas d'un homme de 75 ans, hypertendu, dyslipidémique et porteur d'une cardiopathie hypertensive, qui a été hospitalisé initialement dans un tableau d'hémiplégie gauche. Le patient a été alors mis sous traitement antiagrégant plaquettaire et une anticoagulation par héparine de bas poids moléculaire (HBPM) à dose préventive. Compliqué au 5ème jour de traitement d'un hémocholécyste et hémopéritoine confirmé par un angio-tomodensitométrie abdominale faite en urgence. Le geste a consisté en une cholécystectomie, une hémostase du lit vésiculaire et une évacuation de l'hémopéritoine.
Collapse
Affiliation(s)
- Haithem Rejab
- Faculté de Médecine de Sfax, Service de Chirurgie Viscérale et Générale, Hôpital Habib Bourguiba, Sfax, Tunisie
| | - Aymen Trigui
- Faculté de Médecine de Sfax, Service de Chirurgie Viscérale et Générale, Hôpital Habib Bourguiba, Sfax, Tunisie
| | - Hazem Ben Ameur
- Faculté de Médecine de Sfax, Service de Chirurgie Viscérale et Générale, Hôpital Habib Bourguiba, Sfax, Tunisie
| | - Youssef Majdoub
- Faculté de Médecine de Sfax, Service de Chirurgie Viscérale et Générale, Hôpital Habib Bourguiba, Sfax, Tunisie
| | - Rahma Daoud
- Faculté de Médecine de Sfax, Service de Chirurgie Viscérale et Générale, Hôpital Habib Bourguiba, Sfax, Tunisie
| | - Amira Akrout
- Faculté de Médecine de Sfax, Service de Chirurgie Viscérale et Générale, Hôpital Habib Bourguiba, Sfax, Tunisie
| | - Salah Boujelbene
- Faculté de Médecine de Sfax, Service de Chirurgie Viscérale et Générale, Hôpital Habib Bourguiba, Sfax, Tunisie
| | - Rafik Mzali
- Faculté de Médecine de Sfax, Service de Chirurgie Viscérale et Générale, Hôpital Habib Bourguiba, Sfax, Tunisie
| |
Collapse
|
9
|
Trigui A, Rejab H, Akrout A, Fendri S, Toumi N, Kachaou A, Jemal A, Amar MB, Mzali R. Predictive factors of occult cystobiliary fistula after conservative surgical treatment of the hepatic hydatid cyst A retrospective study of 105 patients. Ann Ital Chir 2019; 90:52-56. [PMID: 30862770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
OBJECTIVES The objective of our study was to determine the predictive factors of their occurrence during conservative surgical treatment of the hepatic hydatid cyst (HHC). PATIENTS AND METHODS We carried out a retrospective review of patients who had undergone conservative surgical treatment of the HHC during 6 years. Univariate analyzes were used to determine the predictive factors of an occult cystobiliary fistula (CBF). RESULTS This current study included 105 patients. Concerning the predictive factors of an CBF regardless of its pattern of evolution, we noted that the presence of fistula was statistically correlated with the a cyst size (bigger than 8.65 cm ; p = 0.003) and with advanced age (p=0.035). Interestingly enough, the correlation to a degenerated cyst (p=0.069) were of little significance. CONCLUSION The size of the cyst greater than 8.65 cm and the advanced age are the risk factors of CBF according to our study. KEY WORDS Biliary Fistula, Diagnosis, Echinococcosis, Hepatic, Prevention and control.
Collapse
|
10
|
Morosi J, Berti N, Akrout A, Picozzi A, Guasoni M, Fatome J. Polarization chaos and random bit generation in nonlinear fiber optics induced by a time-delayed counter-propagating feedback loop. Opt Express 2018; 26:845-858. [PMID: 29401964 DOI: 10.1364/oe.26.000845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Accepted: 12/21/2017] [Indexed: 06/07/2023]
Abstract
In this manuscript, we experimentally and numerically investigate the chaotic dynamics of the state-of-polarization in a nonlinear optical fiber due to the cross-interaction between an incident signal and its intense backward replica generated at the fiber-end through an amplified reflective delayed loop. Thanks to the cross-polarization interaction between the two-delayed counter-propagating waves, the output polarization exhibits fast temporal chaotic dynamics, which enable a powerful scrambling process with moving speeds up to 600-krad/s. The performance of this all-optical scrambler was then evaluated on a 10-Gbit/s On/Off Keying telecom signal achieving an error-free transmission. We also describe how these temporal and chaotic polarization fluctuations can be exploited as an all-optical random number generator. To this aim, a billion-bit sequence was experimentally generated and successfully confronted to the dieharder benchmarking statistic tools. Our experimental analysis are supported by numerical simulations based on the resolution of counter-propagating coupled nonlinear propagation equations that confirm the observed behaviors.
Collapse
|
11
|
Tourrenc JP, Akrout A, Merghem K, Martinez A, Lelarge F, Shen A, Duan GH, Ramdane A. Experimental investigation of the timing jitter in self-pulsating quantum-dash lasers operating at 1.55 microm. Opt Express 2008; 16:17706-17713. [PMID: 18958051 DOI: 10.1364/oe.16.017706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
We report for the first time on the systematic measurement of timing jitter of 40-GHz self-pulsating Fabry-Perot laser based on InAs/InP quantum dashes emitting at 1.55 microm. Two different methods, one based on optical cross-correlation and one on electrical spectrum sideband integration are used and show a good agreement, yielding a jitter of 0.86 ps in the 1 MHz---20 MHz frequency range with a potential of 280 fs for optimized driving conditions. Amplitude noise and high-frequency timing jitter contributions are also discussed.
Collapse
Affiliation(s)
- J P Tourrenc
- CNRS, Laboratory for Photonics and Nanostructures, Route de Nozay, Marcoussis, France
| | | | | | | | | | | | | | | |
Collapse
|
12
|
Merghem K, Akrout A, Martinez A, Moreau G, Tourrenc JP, Lelarge F, Van Dijk F, Duan GH, Aubin G, Ramdane A. Short pulse generation using a passively mode locked single InGaAsP/InP quantum well laser. Opt Express 2008; 16:10675-10683. [PMID: 18607482 DOI: 10.1364/oe.16.010675] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
We report on subpicosecond pulse generation using passively mode locked lasers (MLL) based on a low optical confinement single InGaAsP/InP quantum well active layer grown in one epitaxial step. Systematic investigation of the performances of two-section MLLs emitting at 1.54 microm evidenced pulse width of 860 fs at 21.31 GHz repetition rate, peak power of approximately 500 mW and a time-bandwith product of 0.57. A 30 kHz linewidth of the photodetected radio-frequency electrical spectrum is further demonstrated at 21 GHz which is, to our knowledge, the lowest value ever reported for a quantum well device.
Collapse
Affiliation(s)
- K Merghem
- CNRS, Laboratory for Photonics and Nanostructures, Route de Nozay, 91460 Marcoussis, France.
| | | | | | | | | | | | | | | | | | | |
Collapse
|