Publications of Pierrette GAST
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See detailAlcool et complications pancréatiques
LOLY, Jean-Philippe ULiege; MEURISSE, Nicolas ULiege; GAST, Pierrette ULiege et al

in Revue Médicale de Liège (2019), 74(5-6), 342-348

Alcohol consumption is the main cause of development of chronic pancreatitis and the second etiology of acute pancreatitis. The mortality of acute pancreatitis depends on its necrotic haemorrhagic ... [more ▼]

Alcohol consumption is the main cause of development of chronic pancreatitis and the second etiology of acute pancreatitis. The mortality of acute pancreatitis depends on its necrotic haemorrhagic character and the initial inflammatory response, while pain, malnutrition and diabetes are the main issues in the management of chronic pancreatitis. As medical and endoscopic techniques progress, surgical indications have become increasingly rare but remain indispensable for some patients. The multidisciplinary approach of these patients is the key to the success of care.La consommation d’alcool est la cause principale de développement d’une pancréatite chronique et la seconde étiologie de la pancréatite aiguë. La mortalité de la pancréatite aiguë dépend de son caractère nécrotico-hémorragique et de la réponse inflammatoire initiale tandis que les complications de type douleur, dénutrition et diabète sont les principaux enjeux de la prise en charge de la pancréatite chronique. Au fur et à mesure de l’avancée des techniques médicales et endoscopiques, les indications chirurgicales sont devenues de plus en plus rares, mais restent indispensables pour certains patients. L’approche pluridisciplinaire de ces patients est la clé du succès de la prise en charge. [less ▲]

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See detailOn-site comparison of an enzymatic detergent and a non-enzymatic detergent-disinfectant for routine manual cleaning of flexible endoscopes.
Gonzalez, Jonathan Alfageme; Vanzieleghem, Thomas; Dumazy, Axelle ULiege et al

in Endoscopy International Open (2019), 7(4), 412-420

Background and study aims Flexible endoscopes are potential vectors of pathogen transmission to patients that are subjected to cleaning and high-level disinfection after each procedure. Efficient manual ... [more ▼]

Background and study aims Flexible endoscopes are potential vectors of pathogen transmission to patients that are subjected to cleaning and high-level disinfection after each procedure. Efficient manual cleaning is a prerequisite for effective high-level disinfection. The goal of this study was to demonstrate the impact of the cleaning chemistry in the outcome of the manual cleaning of endoscopes. Materials and methods Twelve endoscopes were included in this study: four colonoscopes, four gastroscopes, two duodenoscopes and two bronchoscopes. This study was designed with two phases; in each of them, the manual cleaning procedure remained identical, but a different detergent was used: a non-enzymatic detergent-disinfectant (NEDD) and an enzymatic detergent (ED). Biopsy and suction channels of endoscopes were sampled using 10 mL of physiological saline at two points: before and after manual cleaning, and adenosine triphosphate (ATP) was measured on each sample. In total, 208 procedures were analyzed for the NEDD phase and 253 for the ED phase. Results For each endoscope type, cleaning endoscopes with ED resulted in larger median decrease in ATP than with NEDD: respectively 99.43 % and 95.95 % for bronchoscopes ( P = 0.0007), 99.28 % and 96.93 % for colonoscopes ( P < 0.0001) and 98.36 % and 95.36 % for gastroscopes ( P < 0.0001). In addition, acceptability rates of endoscopes based on defined post-manual cleaning ATP thresholds (200, 150, 100 or 50 relative light units) for all endoscope types were significantly higher with ED compared to NEDD. Conclusions With all other parameters of manual cleaning remaining unchanged, the enzymatic chemistry of ED provided more consistent and improved cleaning of endoscopes compared to NEDD. Therefore, choice of the detergent for endoscope cleaning has an impact on the outcome of this process. [less ▲]

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See detailIntravenous infusion of lidocaine significantly reduces propofol dose for colonoscopy: a randomised placebo-controlled study
Forster, C.; VANHAUDENHUYSE, Audrey ULiege; GAST, Pierrette ULiege et al

in British Journal of Anaesthesia (2018), 121(5), 1059-1064

Background: Propofol use during sedation for colonoscopy can result in cardiopulmonary complications. Intravenous lidocaine can alleviate visceral pain and decrease propofol requirements during surgery ... [more ▼]

Background: Propofol use during sedation for colonoscopy can result in cardiopulmonary complications. Intravenous lidocaine can alleviate visceral pain and decrease propofol requirements during surgery. We tested the hypothesis that i.v. lidocaine reduces propofol requirements during colonoscopy and improves post-colonoscopy recovery. Methods: Forty patients undergoing colonoscopy were included in this randomised placebo-controlled study. After titration of propofol to produce unconsciousness, patients were given i.v. lidocaine (1.5 mg kg−1 then 4 mg kg−1 h−1) or the same volume of saline. Sedation was standardised and combined propofol and ketamine. The primary endpoint was propofol requirements. Secondary endpoints were: number of oxygen desaturation episodes, endoscopists’ working conditions, discharge time to the recovery room, post-colonoscopy pain, fatigue. Results: Lidocaine infusion resulted in a significant reduction in propofol requirements: 58 (47) vs 121 (109) mg (P=0.02). Doses of ketamine were similar in the two groups: 19 (2) vs 20 (3) mg in the lidocaine and saline groups, respectively. Number of episodes of oxygen desaturation, endoscopists’ comfort, and times for discharge to the recovery room were similar in both groups. Post-colonoscopy pain (P<0.01) and fatigue (P=0.03) were significantly lower in the lidocaine group. Conclusions: Intravenous infusion of lidocaine resulted in a 50% reduction in propofol dose requirements during colonoscopy. Immediate post-colonoscopy pain and fatigue were also improved by lidocaine. Clinical trial registration: NCT 02784860. © 2018 British Journal of Anaesthesia [less ▲]

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See detailPrise en charge initiale de la pancreatite aigue.
Gast, Pierrette ULiege

in Revue Médicale de Liège (2016), 71(2), 108-11

Basic steps of acute pancreatitis initial management are diagnostic assessment, severity prediction, search for concomitant abnormalities being part of the etiologic work up or requiring an early ... [more ▼]

Basic steps of acute pancreatitis initial management are diagnostic assessment, severity prediction, search for concomitant abnormalities being part of the etiologic work up or requiring an early treatment. Adequate volume perfusion is certainly the most important therapeutic measure. [less ▲]

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See detailPrise en charge de l'angiocholite
GAST, Pierrette ULiege

in Revue Médicale de Liège (2014), 69(4), 226-228

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See detailApproche diagnostique d’une angiocholite
GAST, Pierrette ULiege

in Revue Médicale de Liège (2014), 69(3), 162-166

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See detailAlcoholisation of a hepatocarcinoma guided by echoendoscopy
Gast, Pierrette ULiege; Delwaide, Jean ULiege; Gillard, Vincent ULiege et al

in Acta Endoscopica (2006), 36(1), 74

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See detailLa mucosectomie endoscopique pour cancer superficiel de l'oesophage: une alternative a la chirurgie radicale d e resection? Indications, faisabilite et resultats oncologiques
Gast, Pierrette ULiege; Polus, Marc ULiege; Honore, Pierre ULiege et al

in Revue Médicale de Liège (2005), 60(3), 154-62

Radical surgery is the standard of care for resectable esophagus cancers, with mortality less than 5% in heavily trained surgical teams. Nevertheless, the morbidity of surgery is quite high due to the ... [more ▼]

Radical surgery is the standard of care for resectable esophagus cancers, with mortality less than 5% in heavily trained surgical teams. Nevertheless, the morbidity of surgery is quite high due to the procedure and due to the poor status of these patients. Endoscopic mucosal resection seems effective for the resection of superficial malignant lesions of esophagus with an acceptable morbidity profile. A correct staging has to confirm the superficial character of the lesion and exclude deeper infiltration into the digestive wall or nodal involvement. This technique might be an acceptable alternative to surgery or superficial lesions, particularly for patients at high risk for aggressive surgical procedure. [less ▲]

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See detailClinical biliary complications after adult liver transplantation: a prospective study
Detry, Olivier ULiege; Maweja, Sylvie ULiege; Delwaide, Jean ULiege et al

in Acta Gastro-Enterologica Belgica (2000, March), 63(1), 56

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See detailUltrastructural demonstration of histamine in human enterochromaffin like cell granules.
Delwaide, Jean ULiege; Vivario, M.; Belaiche, Jacques ULiege et al

in Gut (1991), 32(7), 834

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See detailLes complications gastro-intestinales du diabete
Belaiche, Jacques ULiege; Gast, Pierrette ULiege; Delwaide, Jean ULiege et al

in Revue Médicale de Liège (1989), 44(18), 533-540

Les complications gastro-intestinales du diabète peuvent toucher la totalité du tube digestif. Elles sont fréquentes et compliquent habituellement un diabète ancien et insulinodépendant. Elles sont ... [more ▼]

Les complications gastro-intestinales du diabète peuvent toucher la totalité du tube digestif. Elles sont fréquentes et compliquent habituellement un diabète ancien et insulinodépendant. Elles sont souvent latentes, mises en évidence par des méthodes isotopiques ou manométriques, parfois invalidantes comme la gastroparésie, la diarrhée et l'incontinence fécale. L'atteinte digestive s'associe toujours à une atteinte nerveuse périphérique et fait partie des manifestations neurovégétatives du diabète. Les troubles digestifs participent à déséquilibrer le diabète et une gastroparésie devra systématiquement être recherchée devant des accidents hypoglycémiques répétés et inexpliqués. Le mécanisme physiopathologique est mal connu et le traitement de ces complications est souvent difficile et décevant. [less ▲]

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