Florence Jeune - Academia.edu (original) (raw)

Papers by Florence Jeune

Research paper thumbnail of Iconographies supplémentaires de l'article : Pancreatic cancer surgical management

Research paper thumbnail of Study Protocol of the PreFiPS Study: Prevention of Postoperative Pancreatic Fistula by Somatostatin Compared With Octreotide, a Prospective Randomized Controlled Trial

Frontiers in Medicine, 2021

Background: Pancreatic fistula (PF), i. e., a failure of the pancreatic anastomosis or closure of... more Background: Pancreatic fistula (PF), i. e., a failure of the pancreatic anastomosis or closure of the remnant pancreas after distal pancreatectomy, is one of the most feared complications after pancreatic surgery. PF is also one of the most common complications after pancreatic surgery, occurring in about 30% of patients. Prevention of a PF is still a major challenge for surgeons, and various technical and pharmacological interventions have been investigated, with conflicting results. Pancreatic exocrine secretion has been proposed as one of the mechanisms by which PF occurs. Pharmacological prevention using somatostatin or its analogs to inhibit pancreatic exocrine secretion has shown promising results. We can hypothesize that continuous intravenous infusion of somatostatin-14, the natural peptide hormone, associated with 10–50 times stronger affinity with all somatostatin receptor compared with somatostatin analogs, will be associated with an improved PF prevention.Methods: A Fren...

Research paper thumbnail of Emergency Management of Caustic Injuries

Trauma Centers and Acute Care Surgery, 2021

Research paper thumbnail of L’envahissement de la veine splénique dans l’adénocarcinome du pancréas gauche : un facteur de mauvais pronostic ?

Journal de Chirurgie Viscérale, 2019

Introduction L’envahissement des vaisseaux spleniques dans l’adenocarcinome du pancreas (ADP) gau... more Introduction L’envahissement des vaisseaux spleniques dans l’adenocarcinome du pancreas (ADP) gauche a ete peu etudie et son impact pronostique reste controverse. Methodes De 2008 a 2016, 164 splenopancreatectomies gauches (SPG) ont ete realisees pour ADP dans 3 centres de chirurgie pancreatique. Une relecture des pieces operatoires a ete realisee par un anatomopathologiste. Les facteurs histologiques associes a l’envahissement des vaisseaux spleniques et a la survie ont ete analyses. Resultats Un envahissement de l’artere splenique (AS + ) et de la veine splenique (VS + ) etait present chez 31 et 55 patients respectivement. Les patients VS+ presentaient une diminution de leur mediane de SG : 32 vs 58 mois (p = 0,01) et SSR 16 vs 41 mois (p = 0,002). Un envahissement VS+ etait associe aux facteurs suivants : pT (p = 0,001), N+ (p = 0,003),LNR (p Conclusion Un envahissement de la VS represente un facteur de mauvais pronostique qui pourrait justifier un traitement neoadjuvant.

Research paper thumbnail of Pancreatic cancer surgical management

La Presse Médicale, 2019

Pancreatic ductal adenocarcinoma (PDAC) remains a dismal prognosis and surgery is the only chance... more Pancreatic ductal adenocarcinoma (PDAC) remains a dismal prognosis and surgery is the only chance for cure. However, only few of the patients have localized tumor eligible for curative complete resection. Preoperative management and well-staging of the disease are the cornerstone for appropriate surgery and major issues to define the best therapeutic strategy. This review focuses on the surgical and optimal perioperative management of PDAC and summarizes updates data on the subject.

Research paper thumbnail of 3D vision and maintenance of stable pneumoperitoneum: a new step in the development of laparoscopic right hepatectomy

Research paper thumbnail of Emergency Abdominal Surgery Outcomes of Critically Ill Patients on Extracorporeal Membrane Oxygenation: A Case-Matched Study with a Propensity Score Analysis

World Journal of Surgery, 2019

Research paper thumbnail of Prognostic Value of Resection Margin Involvement After Pancreaticoduodenectomy for Ductal Adenocarcinoma

Annals of Surgery, 2017

Objective: The aim of the study was to assess the relevance of resection margin status for surviv... more Objective: The aim of the study was to assess the relevance of resection margin status for survival after resection of pancreatic-head ductal adenocarcinoma. Summary Background Data: The definition and prognostic value of incomplete microscopic resection (R1) remain controversial. Methods: Prognostic factors were analyzed in 147 patients included in a prospective multicenter study on the impact of tumor clearance evaluated using a standardized pathology protocol. Results: Thirty patients received neoadjuvant treatment (NAT = 20%); 41 had venous resection (VR = 28%), and 70% received adjuvant chemotherapy. In-hospital mortality was 3% (5/147). Follow-up was 83 months. Tumor clearance was 0, <1.0, <1.5, and <2.0 mm in 35 (25%), 92 (65%), 95 (67%), and 109 (77%) patients, respectively. R0-resection rates decreased from 75% to 35% when changing the definition of R1 status from R1-direct invasion (0 mm) to R1 <1.0 mm. On univariate analysis, clearance <1.0 or <1.5 mm, pT stage, pN stage, LNR ≥0.2, tumor grade 3, and lymphovascular invasion were significantly associated with 5-year survival. On multivariate analysis, pN was the most powerful independent predictor (P = 0.004). Clearance <1.0 or <1.5 mm had borderline significance for the entire cohort, but was relevant in certain subgroups (upfront pancreatectomy (n = 117; P = 0.049); without VR or NAT (n = 87; P = 0.003); N+ without VR or NAT (n = 50; P = 0.004). No N0-patient had R1-0 mm. Additional independent risk predictors were (1) R1 <1.0 mm for the SMA-margin in specific subgroups (upfront pancreatectomy, N0 patients without NAT, N+ patients without NAT or VR; (2) R1-0 mm posterior-margin for the NAT group (P = 0.004). Conclusion: Tumor clearance <1.0 or <1.5 mm was an independent determinants of postresection survival in certain subgroups. To avoid misinterpretation, future trials should specify the clearance margin in millimeter. Trial registration: ClinicalTrials.gov: NCT00918853.

Research paper thumbnail of Laparoscopic liver resection for colorectal liver metastasis patients allows patients to start adjuvant chemotherapy without delay: a propensity score analysis

Surgical endoscopy, Jan 16, 2018

Although adjuvant chemotherapy (AC) is widely used after liver resection (LR) for colorectal live... more Although adjuvant chemotherapy (AC) is widely used after liver resection (LR) for colorectal liver metastasis (CRLM), surgical invasiveness may lead to delay in starting AC, which is preferably started within 8 weeks postoperative. We investigated whether laparoscopic liver resection (LLR) for CRLM facilitates AC start without delay. Between November 2014 and December 2016, 117 consecutive CRLM patients underwent LR followed by AC. LLR and OLR were performed in 30 and 87 patients, respectively. After propensity score matching on clinical characteristics, oncologic features, and type of resection, the time interval between liver resection and AC start was compared between LLR (n = 22) and OLR (n = 44) groups. After propensity score matching, major LR was performed in 8/22 (36%) and 15/44 (34%) cases of LLR and OLR groups, respectively (P = 1.0). Clinical-pathological characteristic and intraoperative findings were comparable between two groups. There was no significant difference in ...

Research paper thumbnail of Small-bowel perforation caused by AdvanCE capsule endoscopy delivery device

Research paper thumbnail of Spontaneous and Isolated Dissection of the Superior Mesenteric Artery: Is there a Place for Revascularization?

Annals of Vascular Surgery, 2014

Spontaneous and isolated dissection of the superior mesenteric artery (SIDSMA) is a rare patholog... more Spontaneous and isolated dissection of the superior mesenteric artery (SIDSMA) is a rare pathology, and the treatment of symptomatic forms is not consensual. The objective of this study was to analyze the management of a series of patients presenting a symptomatic SIDSMA within a structure taking care of intestinal vascular emergencies. From January 2010 to January 2014, the patients presenting a symptomatic SIDSMA were included retrospectively. The clinical and radiologic data as well as the treatment and the follow-up were analyzed. Nine patients were included. Among them, 2 patients presenting with acute mesenteric ischemia were revascularized surgically in emergency, and 1 patient presenting a rupture of a superior mesenteric artery aneurysm had an arteriography followed by medical care. The 6 other patients received medical treatment. Among these, 2 patients developed mesenteric angina requiring surgical revascularization during the follow-up. The revascularization of spontaneous and isolated dissections of the superior mesenteric artery is indicated in the cases complicated with acute mesenteric ischemia, aneurysmal rupture, or in the event of appearance of mesenteric angina or aneurysmal evolution. It should also be discussed in the event of failure of the medical treatment.

Research paper thumbnail of A rare cause of obstructive jaundice and gastric outlet obstruction

World journal of gastrointestinal surgery, Jan 27, 2013

Superior mesenteric artery syndrome is a rare cause of upper gastrointestinal obstruction, and is... more Superior mesenteric artery syndrome is a rare cause of upper gastrointestinal obstruction, and is characterized by 3(rd) duodenal obstruction between the abdominal aorta and the superior mesenteric artery. Classical symptoms are postprandial epigastric pain, nausea, vomiting, and weight loss, or acute upper gastrointestinal obstruction. We herein describe an unusual presentation, with jaundice due to compression of the common bile duct by the gastric obstruction and dilated duodenum.

Research paper thumbnail of Spontaneous and Isolated Dissection of the Superior Mesenteric Artery: Is there a Place for Revascularization?

Annals of Vascular Surgery, 2014

ABSTRACT Spontaneous and isolated dissection of the superior mesenteric artery (SIDSMA) is a rare... more ABSTRACT Spontaneous and isolated dissection of the superior mesenteric artery (SIDSMA) is a rare pathology, and the treatment of symptomatic forms is not consensual. The objective of this study was to analyze the management of a series of patients presenting a symptomatic SIDSMA within a structure taking care of intestinal vascular emergencies. From January 2010 to January 2014, the patients presenting a symptomatic SIDSMA were included retrospectively. The clinical and radiological data as well as the treatment and the follow-up were analyzed. Nine patients were included. Among them, two patients presenting with acute mesenteric ischemia were revascularized surgically in emergency, and one patient presenting a rupture of a superior mesenteric artery aneurysm had an arteriography followed by medical care. The six other patients received medical treatment. Among these, two patients developed mesenteric angina requiring surgical revascularization during the follow-up. The revascularization of spontaneous and isolated dissections of the superior mesenteric artery is indicated in the cases complicated with acute mesenteric ischemia, aneurysmal rupture, or in the event of appearance of mesenteric angina or aneurysmal evolution. It should also be discussed in the event of failure the medical treatment. Copyright © 2015 Elsevier Inc. All rights reserved.

Research paper thumbnail of Iconographies supplémentaires de l'article : Pancreatic cancer surgical management

Research paper thumbnail of Study Protocol of the PreFiPS Study: Prevention of Postoperative Pancreatic Fistula by Somatostatin Compared With Octreotide, a Prospective Randomized Controlled Trial

Frontiers in Medicine, 2021

Background: Pancreatic fistula (PF), i. e., a failure of the pancreatic anastomosis or closure of... more Background: Pancreatic fistula (PF), i. e., a failure of the pancreatic anastomosis or closure of the remnant pancreas after distal pancreatectomy, is one of the most feared complications after pancreatic surgery. PF is also one of the most common complications after pancreatic surgery, occurring in about 30% of patients. Prevention of a PF is still a major challenge for surgeons, and various technical and pharmacological interventions have been investigated, with conflicting results. Pancreatic exocrine secretion has been proposed as one of the mechanisms by which PF occurs. Pharmacological prevention using somatostatin or its analogs to inhibit pancreatic exocrine secretion has shown promising results. We can hypothesize that continuous intravenous infusion of somatostatin-14, the natural peptide hormone, associated with 10–50 times stronger affinity with all somatostatin receptor compared with somatostatin analogs, will be associated with an improved PF prevention.Methods: A Fren...

Research paper thumbnail of Emergency Management of Caustic Injuries

Trauma Centers and Acute Care Surgery, 2021

Research paper thumbnail of L’envahissement de la veine splénique dans l’adénocarcinome du pancréas gauche : un facteur de mauvais pronostic ?

Journal de Chirurgie Viscérale, 2019

Introduction L’envahissement des vaisseaux spleniques dans l’adenocarcinome du pancreas (ADP) gau... more Introduction L’envahissement des vaisseaux spleniques dans l’adenocarcinome du pancreas (ADP) gauche a ete peu etudie et son impact pronostique reste controverse. Methodes De 2008 a 2016, 164 splenopancreatectomies gauches (SPG) ont ete realisees pour ADP dans 3 centres de chirurgie pancreatique. Une relecture des pieces operatoires a ete realisee par un anatomopathologiste. Les facteurs histologiques associes a l’envahissement des vaisseaux spleniques et a la survie ont ete analyses. Resultats Un envahissement de l’artere splenique (AS + ) et de la veine splenique (VS + ) etait present chez 31 et 55 patients respectivement. Les patients VS+ presentaient une diminution de leur mediane de SG : 32 vs 58 mois (p = 0,01) et SSR 16 vs 41 mois (p = 0,002). Un envahissement VS+ etait associe aux facteurs suivants : pT (p = 0,001), N+ (p = 0,003),LNR (p Conclusion Un envahissement de la VS represente un facteur de mauvais pronostique qui pourrait justifier un traitement neoadjuvant.

Research paper thumbnail of Pancreatic cancer surgical management

La Presse Médicale, 2019

Pancreatic ductal adenocarcinoma (PDAC) remains a dismal prognosis and surgery is the only chance... more Pancreatic ductal adenocarcinoma (PDAC) remains a dismal prognosis and surgery is the only chance for cure. However, only few of the patients have localized tumor eligible for curative complete resection. Preoperative management and well-staging of the disease are the cornerstone for appropriate surgery and major issues to define the best therapeutic strategy. This review focuses on the surgical and optimal perioperative management of PDAC and summarizes updates data on the subject.

Research paper thumbnail of 3D vision and maintenance of stable pneumoperitoneum: a new step in the development of laparoscopic right hepatectomy

Research paper thumbnail of Emergency Abdominal Surgery Outcomes of Critically Ill Patients on Extracorporeal Membrane Oxygenation: A Case-Matched Study with a Propensity Score Analysis

World Journal of Surgery, 2019

Research paper thumbnail of Prognostic Value of Resection Margin Involvement After Pancreaticoduodenectomy for Ductal Adenocarcinoma

Annals of Surgery, 2017

Objective: The aim of the study was to assess the relevance of resection margin status for surviv... more Objective: The aim of the study was to assess the relevance of resection margin status for survival after resection of pancreatic-head ductal adenocarcinoma. Summary Background Data: The definition and prognostic value of incomplete microscopic resection (R1) remain controversial. Methods: Prognostic factors were analyzed in 147 patients included in a prospective multicenter study on the impact of tumor clearance evaluated using a standardized pathology protocol. Results: Thirty patients received neoadjuvant treatment (NAT = 20%); 41 had venous resection (VR = 28%), and 70% received adjuvant chemotherapy. In-hospital mortality was 3% (5/147). Follow-up was 83 months. Tumor clearance was 0, <1.0, <1.5, and <2.0 mm in 35 (25%), 92 (65%), 95 (67%), and 109 (77%) patients, respectively. R0-resection rates decreased from 75% to 35% when changing the definition of R1 status from R1-direct invasion (0 mm) to R1 <1.0 mm. On univariate analysis, clearance <1.0 or <1.5 mm, pT stage, pN stage, LNR ≥0.2, tumor grade 3, and lymphovascular invasion were significantly associated with 5-year survival. On multivariate analysis, pN was the most powerful independent predictor (P = 0.004). Clearance <1.0 or <1.5 mm had borderline significance for the entire cohort, but was relevant in certain subgroups (upfront pancreatectomy (n = 117; P = 0.049); without VR or NAT (n = 87; P = 0.003); N+ without VR or NAT (n = 50; P = 0.004). No N0-patient had R1-0 mm. Additional independent risk predictors were (1) R1 <1.0 mm for the SMA-margin in specific subgroups (upfront pancreatectomy, N0 patients without NAT, N+ patients without NAT or VR; (2) R1-0 mm posterior-margin for the NAT group (P = 0.004). Conclusion: Tumor clearance <1.0 or <1.5 mm was an independent determinants of postresection survival in certain subgroups. To avoid misinterpretation, future trials should specify the clearance margin in millimeter. Trial registration: ClinicalTrials.gov: NCT00918853.

Research paper thumbnail of Laparoscopic liver resection for colorectal liver metastasis patients allows patients to start adjuvant chemotherapy without delay: a propensity score analysis

Surgical endoscopy, Jan 16, 2018

Although adjuvant chemotherapy (AC) is widely used after liver resection (LR) for colorectal live... more Although adjuvant chemotherapy (AC) is widely used after liver resection (LR) for colorectal liver metastasis (CRLM), surgical invasiveness may lead to delay in starting AC, which is preferably started within 8 weeks postoperative. We investigated whether laparoscopic liver resection (LLR) for CRLM facilitates AC start without delay. Between November 2014 and December 2016, 117 consecutive CRLM patients underwent LR followed by AC. LLR and OLR were performed in 30 and 87 patients, respectively. After propensity score matching on clinical characteristics, oncologic features, and type of resection, the time interval between liver resection and AC start was compared between LLR (n = 22) and OLR (n = 44) groups. After propensity score matching, major LR was performed in 8/22 (36%) and 15/44 (34%) cases of LLR and OLR groups, respectively (P = 1.0). Clinical-pathological characteristic and intraoperative findings were comparable between two groups. There was no significant difference in ...

Research paper thumbnail of Small-bowel perforation caused by AdvanCE capsule endoscopy delivery device

Research paper thumbnail of Spontaneous and Isolated Dissection of the Superior Mesenteric Artery: Is there a Place for Revascularization?

Annals of Vascular Surgery, 2014

Spontaneous and isolated dissection of the superior mesenteric artery (SIDSMA) is a rare patholog... more Spontaneous and isolated dissection of the superior mesenteric artery (SIDSMA) is a rare pathology, and the treatment of symptomatic forms is not consensual. The objective of this study was to analyze the management of a series of patients presenting a symptomatic SIDSMA within a structure taking care of intestinal vascular emergencies. From January 2010 to January 2014, the patients presenting a symptomatic SIDSMA were included retrospectively. The clinical and radiologic data as well as the treatment and the follow-up were analyzed. Nine patients were included. Among them, 2 patients presenting with acute mesenteric ischemia were revascularized surgically in emergency, and 1 patient presenting a rupture of a superior mesenteric artery aneurysm had an arteriography followed by medical care. The 6 other patients received medical treatment. Among these, 2 patients developed mesenteric angina requiring surgical revascularization during the follow-up. The revascularization of spontaneous and isolated dissections of the superior mesenteric artery is indicated in the cases complicated with acute mesenteric ischemia, aneurysmal rupture, or in the event of appearance of mesenteric angina or aneurysmal evolution. It should also be discussed in the event of failure of the medical treatment.

Research paper thumbnail of A rare cause of obstructive jaundice and gastric outlet obstruction

World journal of gastrointestinal surgery, Jan 27, 2013

Superior mesenteric artery syndrome is a rare cause of upper gastrointestinal obstruction, and is... more Superior mesenteric artery syndrome is a rare cause of upper gastrointestinal obstruction, and is characterized by 3(rd) duodenal obstruction between the abdominal aorta and the superior mesenteric artery. Classical symptoms are postprandial epigastric pain, nausea, vomiting, and weight loss, or acute upper gastrointestinal obstruction. We herein describe an unusual presentation, with jaundice due to compression of the common bile duct by the gastric obstruction and dilated duodenum.

Research paper thumbnail of Spontaneous and Isolated Dissection of the Superior Mesenteric Artery: Is there a Place for Revascularization?

Annals of Vascular Surgery, 2014

ABSTRACT Spontaneous and isolated dissection of the superior mesenteric artery (SIDSMA) is a rare... more ABSTRACT Spontaneous and isolated dissection of the superior mesenteric artery (SIDSMA) is a rare pathology, and the treatment of symptomatic forms is not consensual. The objective of this study was to analyze the management of a series of patients presenting a symptomatic SIDSMA within a structure taking care of intestinal vascular emergencies. From January 2010 to January 2014, the patients presenting a symptomatic SIDSMA were included retrospectively. The clinical and radiological data as well as the treatment and the follow-up were analyzed. Nine patients were included. Among them, two patients presenting with acute mesenteric ischemia were revascularized surgically in emergency, and one patient presenting a rupture of a superior mesenteric artery aneurysm had an arteriography followed by medical care. The six other patients received medical treatment. Among these, two patients developed mesenteric angina requiring surgical revascularization during the follow-up. The revascularization of spontaneous and isolated dissections of the superior mesenteric artery is indicated in the cases complicated with acute mesenteric ischemia, aneurysmal rupture, or in the event of appearance of mesenteric angina or aneurysmal evolution. It should also be discussed in the event of failure the medical treatment. Copyright © 2015 Elsevier Inc. All rights reserved.