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Aim:Few patients with pancreatic cancer are eligible for resection. In the remainder, estimation of prognosis is important to optimise various aspects of care, including palliation of biliary obstruction and trial of chemotherapy.

Background: Band infection after gastric banding is a relatively rare complication. In most cases, it is manifested by abdominal pain associated with fever, and/or an abscess surrounding the access port.The treatment of choice consists of band removal and antibiotic therapy, and is usually effective. Methods: Among the 322 patients having undergone gastric banding in our department, we report a 31-year-old woman who developed an infection of the band complicated by splenic and portal vein thrombosis 21 months after gastric banding. Results: BMI was 40.9 kg/m2 when she underwent gastric banding. Postoperative course was uneventful, and excess weight loss reached 105% after 18 months. An abdominoplasty combined with bilateral mammoplasty and thigh dermolipectomy were performed. About 3 weeks later, she developed an otitis with fever and left upper abdominal pain. Despite antibiotics, pain and fever persisted. The operative wounds showed no sign of infection, and there was no sign of peritonitis. Computerized tomography showed a left subdiaphragmatic abscess surrounding the catheter and thrombosis of the splenic and portal veins. Treatment consisted of band removal, antibiotics and heparin. Recovery was uneventful with complete resolution of the thrombosis. Conclusions: Late band infection after gastric banding is rare, and is usually secondary to band erosion. Our case demonstrates that severe band infection can be caused by any infection causing bacteremia. Prompt band removal along with antibiotic therapy is the treatment of choice. Rapid treatment of any infection is mandatory in patients with a gastric band. Antibiotic prophylaxis during surgical and dental procedures could be useful in these patients.

Introduction : le recours a` des donneurs vivants est une des solutions a` la pe´nurie d'organes en transplantation re´nale. Re´cemment des techniques de pre´le`vement laparoscopique ont e´te´ de´crites, permettant de re´duire la morbidite´, la dure´e de l'hospitalisation et l'arre^t de travail du donneur. Elles sont cependant difficiles, et peuvent exposer le greffon a` des risques. Me´thode : nous avons introduit le pre´le`vement de rein par laparoscopie par e´tapes, notamment en utilisant la vide´oconfe´rence a` partir d'un centre d'excellence. Nous rapportons l'analyse prospective de nos re´sultats initiaux. Re´sultats : nous avons effectue´ dix pre´le`vements, trois a` gauche et sept a` droite ; il n'y a pas eu de conversion en laparotomie. Le temps d'ische´mie chaude a e´te´ de cinq minutes en moyenne, n'exce´dant pas trois minutes lors de nos six derniers pre´le`vements. Les patients ont quitte´ l'ho^pital 4,8 jours apre`s l'ope´ration en moyenne. Les greffons ont tous pre´sente´ une excellente fonction. Conclusion : la qualite´ de ces re´sultats initiaux, lie´s a` une introduction prudente de la me´thode, devrait permettre a` terme de renforcer la motivation des donneurs potentiels et de leur entourage, augmentant ainsi le nombre d'organes a` greffer.

Summary.: Introduction: Alveolar hydatid disease is an uncommon parasitosis found in the northern hemisphere, caused by the larval stage of a tapeworm growing in the liver: Echinococcus multilocularis. It behaves like a malignant tumor, producing liver necrosis and invading the biliary tract, main vessels and surrounding structures. Methods: Review of the different therapeutic approaches in hepatic alveolar echinococcosis over 21 years in an epidemic area. Results: The various surgical approaches (all types of hepatectomy, palliative surgical procedures and liver transplantation) were combined with medical, endoscopic and radiological interventional treatment. Recently, asymptomatic forms were more frequently encountered. Conclusions: The wide use of ultrasonography and specific serological tests have led to early diagnosis, allowing more curative hepatectomies.

Air leaks are common after lung resection, and normally seal with conservative therapy. Re-thoracotomy is rarely indicated. We present three patients with prolonged air leak and partial pneumothorax treated by thoracoscopy. Complete lung re-expansion followed immediately. Postoperative air leak was minimal. The chest tubes were removed after three or four days. Complete division of adhesions and sealing of the leak(s) are essential. Thoracoscopy may be the method of choice for prolonged air leak unresponding to conservative therapy provided the bronchial stump or suture have been verified by endoscopy.