EUS-Guided Biliary Drainage

The echoendoscopic biliary drainage is an option to treat obstructive jaundices when ERCP drainage fails. These procedures compose alternative methods to the side of surgery and percutaneous transhepatic biliary drainage, and it was only possible by the continuous development and improvement of echoendoscopes and accessories. The development of linear setorial array echoendoscopes in early 1990 brought a new approach to diagnostic and therapeutic dimenion on echoendoscopy capabilities, opening the possibility to perform punction over direct ultrasonographic view. Despite of the high success rate and low morbidity of biliary drainage obtained by ERCP, difficulty could be found at the presence of stent tumor ingrown, tumor gut compression, periampulary diverticula, and anatomic variation. The echoendoscopic technique starts performing punction and contrast of the left biliary tree. When performed from gastric wall, the access is made through hepatic segment III. From duodenum, direct common bile duct punction. Dilatation is required before stent introduction, and a plastic or metallic stent is introduced. This phrase should be replaced by: diathermic dilatation of the puncturing tract is required using a 6F cystostome. The technical success of hepaticogastrostomy is near 98%, and complications are present in 36%: pneumoperitoneum, choleperitoneum, infection, and stent disfunction. To prevent bile leakage, we have used the 2 stent techniques, the first stent introduced was a long uncovered metallic stent (8 or 10 cm), and inside this first stent a second fully covered stent of 6 cm was delivered to bridge the bile duct and the stomach. Choledochoduodenostomy overall success rate is 92% and described complications include, in frequency order, pneumoperitoneum and focal bile peritonitis, present in 19%. By the last 10 years, the technique was especially performed in reference centers, by ERCP experienced groups, and this seems to be a general guideline to safer procedure execution

Sainte-Radegonde – Le gisement du paléolithique inférieur d’Inières

Lien Atlas (MCC) :http://atlas.patrimoines.culture.fr/atlas/trunk/index.php?ap_theme=DOM_2.01.02&ap_bbox=2.594;44.288;2.673;44.373 Déjà prospecté en 1995, ce site se situe à la limite nord du bassin des Bastries. Au sud de Rodez, dès le début du Miocène, se met en place l’ébauche d’un nouveau réseau hydrographique et l’organisation d’un drainage est-ouest va supplanter le vieux modèle de l’Oligocène. Les drains se concentrent dans de larges couloirs, peu profonds en surface, de plateaux qu’il..

Rodelle – La Goudalie

Le Causse Comtal, au fil des prospections, livre peu à peu des éléments tangibles attestant d’une présence bien établie des néandertaliens sur notre territoire. Le site de La Goudalie présente un faciès Moustérien à denticulé qui pourrait se situer vers -115 000 ans. Au Nord de Rodez, sur la commune de Rodelle, le Causse Comtal est tranché net par le Dourdou, petit ruisseau à qui l’on doit également le creusement du canyon de Bozouls. Toute sa rive gauche est bordée de hautes falaises parfois..

Brewing, winemaking and distilling: an overview of wastewater treatment and utilization schemes (Part IV - Chapter 35)

Brewing, winemaking and distilling: an overview of wastewater treatment and utilization schemes (Part IV - Chapter 35

Effects of sulfate on lactate and C2-, C3- volatile fatty acid anaerobic degradation by a mixed microbial culture

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