[Analysis of the drainage fluid after cephalic duodenopancreatectomy: a reliable clinical criterion]

The authors have retrospectively analysed the drainage fluid of 39 patients undergoing Whipple's operation over a 18-year period. The aim of the study was to assess whether the volume and amylase concentration of the drainage fluid were good criteria of healing of the pancreatico-jejunal anastomosis. The patients have been divided into two groups: Group I (30 patients) with no complications at the pancreatico-jejunostomy--Group II (9 patients) with a pancreatic leak. The analysis of the volume, amylase concentration and amylase index (Log of the amylase concentration x volume) showed that the groups had clearly different profiles: in group I all three criteria were rapidly decreasing, while they remained abnormally high in group II. Those criteria may help the clinician in the monitoring of individual patients; they also may prove useful in prospective studies evaluating new means of prevention of this anastomosis.

[Postoperative and stress-induced alithiasic cholecystitis. Report on 25 cases seen between 1960 and 1980 (author's transl)]

Acute alithiasic cholecystitis developed in 25 patients during the course of surgical, traumatic, or infective aggressions. Diagnosis was usually by ultrasonography, which proved to be the best means for exploration of the accessory biliary pathways during the postoperative period. If not, in the absence of a diagnosis, the lesion was usually discovered during a repeat operation because of sepsis. Findings during operation are frequently difficult to interpret. When confronted with a large but only slightly oedematous gallbladder, and when the rest of the abdomen appears normal, this should be sufficient to establish the diagnosis and to perform a cholecystectomy. Prevention of such accidents requires ultrasonographic surveillance of the gallbladder in high risk patients. The value of cholecystokinin is discussed.