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ACTA ENDOSCOPICA

R I ~ D A C T E U R S E N CHIEF/EDITORS P. MAINGUET (Bruxelles), F. VICARI (Nancy)

Ch. FLORENT (Paris), G. GAY (Nancy), M. JUNG (Mayence) R i ~ D A C T E U R S I C O E D I T O R S

Allemagne : M. CLASSEN (Mtinich), M. MAIER (Puttlingen), B. MANEGOLD (Mannheim), A. PF~IPFI~R (Miinieh).

Angleterre : A.T.R...AXON (Leeds), Ch. WILLIAMS (Londres).

Belglque : J. BELAICHE (Li6ge), J,.C. DEBONGNIE (Ottignies), P. DEPREZ (Bruxelles), J. DEVIERE (BruxeUes),

V. GILLARD (Li6ge).

Espague : J.R. ARMENGOL MIRO (Barcelone), J. BOIX I VALVERDE (Barcelone), J.M. BORDAS (Barcelone), J.M. POU FERNANDEZ (Barcelone), J.A. RAM1REZ ARMENGOL (Madrid), J.L. VASQUEZ IGLESIAS (La Corogne).

France : J. BOYER (Angers), J. FAIVRE (Dijon), J.M. CANARD (Paris), R. GIUL1 (Paris), J.F. REY (Saint-Laurent-du-Var), D. SAUTEREAU (Limoges).

Hollande : K. HUIBREGTSE (Amsterdam), G, TYTGAT (Amsterdam).

Honkie : L. SIMON (Szekszard).

Italie : G. BATrAGLIA (Padoue), G. CALE'Iq'I (Bologne), G. COSTAMAGNA (Rome), F. ROSSINI (Turin), A. RUSSO (Catane).

Portugal : J.M. CARRILHO RIBEIRO (Lisbonne), DINIZ DE FREITAS (Lisboane), GINESTAL DA CRUZ (Lisbonne), LOMBA VIANA (Lisbonne),

MASCARENHAS SARAIVA (Lisbonne).

Roumanie : A. OPROIU (Bucarest), O. PASCU (Cluj Napoca), C. STANCIU (Iasi), Simgna VALEAN (Cluj).

Suisse : Ph. MONNIER (Lausanne), M. VOIROL

(Yverdon-les-Bains), Christa MEYENBERGER (Saint-Gall).

Teh6coslovaquie : Z. MARATKA (Prague).

C O R R E S P O N D A N T S Afrique : F. Klotz (Dakar)

Argentine (Buenos Aires) : Aria Maria BOSCO, V.E. FUCILE, Maria Claudia MILANO, C. VARSKY, D. ZAGALSKY.

Canada : N.E. MARCON (Toronto), A. WATIER (Sherbrooke).

Coiombie : S. FASSLER (Bogota), A. PENALOZA (Bogota).

Israel : M. BEER GABEL (J6msaiem), P. ROZEN (Tel Aviv).

Japon : K. KAWAI (Osaka), T. KIDOKORO (Nagoya), T. NAGAYO (Nagoya).

Maroe : Naima AMRANI (Rabat), A. BENAISSA (Rabat).

USA : J. WAYE (New York), K.F. BINMOELLER (San Diego).

R U B R I Q U E S

A n a p a t h : Marie-Danielle DIEBOLD (Reims), Monique FABRE (Paris), Anne JOURET (Bruxelles).

Bancs d'essai : Anne LE SIDANER (Limoges), J.Ch. LETARD (Poitiers).

Cas cliniques : J. WEBER (Luxembonrg).

Ccelio-chirurgie : J. LEROY (Lisieux), M. VAN KEMMEL (Lille), J. MARESCAUX (Strasbourg), J.F. GIGOT (Bruxelles), A. MONTORI (Rome).

Echo-endoscopie : H. GRIMM (Kiehl), M. GIOVANNINI (Marseille), L. PALAZZO (Paris), V. GILLARD (Liege).

Ent~roseopie : G. GAY (Nancy), F.P. ROSSINI (Turin), A. VAN GOSSUM (Bruxelles).

Europe : M. GREFF (Saint-Lanrent-du-Var), V. LAMY (Charleroi), A. MARTIN (Padoue).

Gyn#cologie : H. Ch. VERHOEVEN (Dtisseldorf).

F M C - H G E : Ph. HOUCKE (Lille).

Image : J.S. DELMOTI'E (Lille), J. LAURENT (Nancy).

Organisation des Cours Europ~ens d ' E n d o s c o p i e Digestive : J.Ch. AUDIGIER (Saint-Etienne), F. COSENTINO (Milan), D. COUMAROS (Strasbourg).

9 P~rindologie : A. WATIER (Sherbrooke).

Pharmacologie Clinique : A. PAPAZIAN (Amiens).

Proctologie: P. DIETERLING (Nancy).

Radiologie : R. DONDELINGER (Liege). D. RI~GENT (Nancy).

R . M . N . : Val&ie LAURENT (Nancy), C. MATOS (Bruxelles), P.J. VALETTE (Lyon).

S F E D : J. LAPUELLE (Toulouse).

V~t~rinaire : F. DARGENT (Paris).

R I ~ D A C T I O N ENDOSCOPICA BRUXELLES B~t. Les Arches, Site U.C.L., rue Martin V, 40, Boite n ~ 4, B 1200 BRUXELLES.

T61. : 00 (32) 2762.79.68.

I~DITION A D M I N I S T R A T I O N ENDOSCOPICA NANCY 127, rue Saint-Dizier, 54000 NANCY.

T61. : 03.83.37.44.38 - Fax : 03.83.35.34.53.

e-mail : [email protected] Site: www.acta-endoscopica.com Direction : F. VICARI.

Sect6tariat-Publicit6 : L. DEVRED.

Photographie: M. MERLE.

Relations : G. GAY.

Conseil Juridique : Ch. DEMOYEN (Paris).

A B O N N E M E N T S 2005 (5 num6ros par an + 2 num6ros sp6eianx) Pour la France, port inclus :

L e num~ro . . . 43 A b o n n e m e n t :

Tarif normal . . . 130 Etudiants . . . 82 Pour I'~tranger :

A b o n n e m e n t (port inclus) :

Europe . . . 180 Autres pays . . . 1954E

Les commandes et r~glements sont ~t adresser Orders and p a y m e n t s m u s t be sent to : ENDOSCOPICA, 127, rue Saint-Dizier, F-54000 NANCY

T61. : 03 83 37 44 38 - Fax : 03 83 35 34 53 - Banque : Credit Agricole ~ 6, rue des Michottes,

F-54000 NANCY - Compte n ~ 700 5314 6140

E d i t o r i a l

L e 18 e C o u r s I n t e n s i f E u r o p d e n d ' E n d o s c o p i e D i g e s t i v e e s t o r g a n i s 6 c e t t e a n n & e n c o r e h S t r a s b o u r g p a r la S M I E R . L a f o r m u l e s e r e n o u v e l l e t o u t e n p o u r s u i v a n t l e s o b j e c t i f s q u e c e c o u r s a t o u j o u r s r e c h e r c h 6 s : 1) o f f r i r a u x g a s t r o - e n t 6 r o l o g u e s u n e f o r m a t i o n p r a t i q u e e t d e q u a l i t 6 , d i v e r s i f i 6 e e t m u l t i d i s c i p l i n a i r e , c e n t r 6 e s u r l ' e n d o s c o p i e e t l e s a u t r e s t e c h n i q u e s d ' i m a g e r i e m 6 d i c a l e p o u r u n m e i l l e u r d i a g n o s t i c d e s m a l a d i e s d i g e s t i v e s ; 2) a b o r d e r l e s a s p e c t s t e c h n i q u e s e t p r a t i q u e s a u t a n t q u e m 6 d i c a u x d e s e x a m e n s e n d o s c o p i q u e s ; 3) r d s e r v e r u n e l a r g e p l a c e ~ la p r 6 s e n t a t i o n d e s t e c h n i q u e s l e s p l u s n o u v e l l e s , s a n s n 6 g l i g e r c e l l e s q u e n o u s p r a t i q u o n s e n r o u t i n e ; 4) f a v o r i s e r l ' 6 c h a n g e s u r t o u s c e s s u j e t s a u n i v e a u e u r o p d e n ,

L e p r o g r a m m e e s t a m b i t i e u x m a i s n o t r e v d n 6 r a b l e s o c i 6 t 6 - e l l e f u t l a p r e m i b r e s o c i 6 t 6 d ' e n d o s c o p i e e u r o p 6 e n n e , f o n d 6 e le 12 m a r s 1955 - a s u r e l e v e r c e d 6 f i c h a q u e a n n 6 e e t le s u c c 6 s c o n s t a n t d e c e c o u r s e n e s t la p r e u v e t a n g i b l e . C e s u c c ~ s e s t dfi a v a n t t o u t a u t r a v a i l i n l a s s a b l e d e G 6 r a r d G A Y p o u r a s s u r e r l ' o r g a n i s a t i o n p r a t i q u e d u c o u r s , c o n c r 6 t i s e r l e p r o g r a m m e 6 1 a b o r 6 c o l l 6 g i a l e m e n t p a r l e C o n s e i l d ' A d m i n i s t r a t i o n e t m a i n t e n i r s o n c a r a c t 6 r e e u r o p d e n . A l ' h e u r e ot~ G d r a r d s o u h a i t e p a s s e r la m a i n , j e v o u d r a i s , a u n o m d u C o n s e i l d ' A d m i n i s t r a t i o n e t d e t o u s c e u x q u i o n t p a r t i c i p 6 a v e c f i d d l i t 6 a u C o u r s , le r e m e r c i e r c h a l e u r e u s e m e n t p o u r a v o i r s u 6 1 e v e r la q u a l i t 6 s c i e n t i f i q u e d e la r d u n i o n , m a i n t e n i r s o n c a r a c t b r e e u r o p d e n si b i e n i l l u s t r 6 p a r s a t e n u e h S t r a s b o u r g e t p r 6 s e r v e r s o n c a r a c t & e c o n v i v i a l .

L e s d 6 f i s q u i a t t e n d e n t la S M I E R s o n t ~ l ' a u n e d e s o n p a s s 6 b r i l l a n t . L e C o n s e i l d ' A d m i n i s t r a t i o n d o i t p r o g r e s s i v e m e n t s e r e n o u v e l e r p o u r a s s o c i e r d a v a n t a g e d e j e u n e s c o l l ~ g u e s ~ l ' 6 1 a b o r a t i o n d u p r o g r a m m e e t m a i n t e n i r l a p l a c e r 6 s e r v 6 e a u x t e c h n i q u e s n o u v e l l e s . L a p a r t i c i p a t i o n d e s c o l l b g u e s e u r o p 6 e n s d o i t 6 t r e a c c r u e d a n s l e f u t u r , p e u t - 6 t r e e n 6 v o l u a n t v e r s l ' u t i l i s a t i o n d e l ' a n g l a i s p o u r t o u t e s l e s c o n f 6 r e n c e s o u e n o f f r a n t u n e t r a d u c t i o n s i m u l t a n 6 e q u i n ' a j u s q u ' g p r 6 s e n t p u a t r e p r o p o s 6 e p o u r d e s m o t i f s f i n a n c i e r s . C e c i p e r m e t t r a i t d ' o u v r i r l a r 6 u n i o n ~ d e s g a s t r o - e n t d r o l o g u e s d e t o u t e l ' E u r o p e , n o t a m m e n t d ' E u r o p e o r i e n t a l e . L e c a r a c t ~ r e m u l t i d i c i p l i n a i r e d u C o u r s d o i t a u g m e n t e r e n r e c h e r c h a n t la p a r t i c i p a t i o n d e n o s a m i s r a d i o l o g u e s , c h i r u r g i e n s , p a t h o l o g i s t e s . . .

Si n o u s r e l e v o n s c e s d 6 f i s , le C o u r s I n t e n s i f d ' E n d o s c o p i e D i g e s t i v e d e la S M I E R p o u r r a p r d t e n d r e h l ' a c c r 6 d i t a t i o n q u i r e c o n n a t t r a s a v a l e u r 6 d u c a t i v e d a n s l e c a d r e d e l a f o r m a t i o n m 6 d i c a l e c o n t i n u e . L a S M I E R n ' a p a s l a p r 6 t e n t i o n d e c o n c u r r e n c e r d ' a u t r e s m a n i f e s t a t i o n s e t a t o u j o u r s r e c h e r c h 6 la c o l l a b o r a t i o n , n o t a m m e n t a v e c la S o c i 6 t 6 F r a n q a i s e d ' E n d o s c o p i e D i g e s t i v e e t l ' A s s o c i a t i o n d e F o r m a t i o n M 6 d i c a l e C o n t i n u e e n H d p a t o - G a s t r o - E n t 6 r o l o g i e , p a r t e n a i r e s d u C o u r s . L ' 6 v o l u t i o n d e s p r a t i q u e s e t d e l a r 6 g l e m e n t a t i o n a u n i v e a u e u r o p 6 e n , r e n f o r c e n t c o n s i d 6 r a b l e m e n t l ' i m p a c t d e la F M C s u r n o t r e v i e p r o f e s s i o n n e l l e e t la f o r m u l e o r i g i n a l e p r o p o s d e p a r l a S M I E R g a r d e r a d o n c d a n s le f u t u r t o u t s o n i n t 6 r & .

L e 18 e C o u r s I n t e n s i f d ' E n d o s c o p i e D i g e s t i v e i n a u g u r e u n e n o u v e l l e f o r m u l e p l u s c o n d e n s d e , s u r d e u x d e m i - j o u r n 6 e s , s a n s r i e n p e r d r e d e t o u t c e q u e n o u s a v o n s r a p p e l 6 c i - d e s s u s e t q u i f a i t s o n s u c c ~ s . L e p r o g r a m m e e s t a t t r a c t i f , s ' o u v r e a u x r e l a t i o n s d e l ' e n d o s c o p i e a v e c la c h i r u r g i e , l ' a n a t o m o - p a t h o l o g i e , l a r a d i o l o g i e . L e s a s p e c t s p r a t i q u e s n ' o n t p a s 6 t 6 n 6 g l i g 6 s , n o t a m m e n t l ' a n e s t h 6 s i e e t l a d 6 s i n f e c t i o n d e s e n d o s c o p e s . N o u s e s p 6 r o n s d o n c v o u s a c c u e i l l i r n o m b r e u x ~ S t r a s b o u r g c a r v o t r e p a r t i c i p a t i o n e s t i n d i s p e n s a b l e a u d 6 v e l o p p e m e n t d u C o u r s d a n s l e s a n n 6 e s ~ v e n i r . N o u s s o u h a i t o n s a u s s i r e m e r c i e r ici t o u s n o s p a r t e n a i r e s d a n s l ' o r g a n i s a t i o n d e c e C o u r s : l ' i n d u s t r i e p h a r m a c e u t i q u e , l e s f a b r i c a n t s d ' e n d o s c o p e s e t d ' a c c e s s o i r e s d o n t l ' a i d e e s t p r 6 c i e u s e e t d o n t l a p r 6 s e n c e r e n f o r c e l e s o b j e c t i f s d e f o r m a t i o n d e la r 6 u n i o n , e n p r d s e n t a n t l e u r s n o u v e a u x m a t 6 r i e l s d a n s la s a l l e d ' e x p o s i t i o n e t l a S o c i d t 6 A l e o u p o u r l ' o r g a n i s a t i o n p r a t i q u e . Q u e c e 18 e C o u r s I n t e n s i f d ' E n d o s c o p i e D i g e s t i v e a p p o r t e h c h a c u n l e s i n f o r m a t i o n s s c i e n t i f i q u e s d e q u a l i t 6 q u i e n r i c h i r o n t n o t r e p r a t i q u e d e d e m a i n e t q u ' i l f a v o r i s e l e s c o n t a c t s p e r s o n n e l s p o u r u n e m e i l l e u r e i n t 6 g r a t i o n e u r o p d e n n e d e n o s p r a t i q u e s p r o f e s s i o n n e l l e s .

B i e n v e n u e h S t r a s b o u r g !

M . D E L V A U X

V o l u m e 3 5 - N ~ 5 - 2 0 0 5 I

Cet article des Editions Lavoisier est disponible en acces libre et gratuit sur archives-acen.revuesonline.com

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A C T A E N D O S C O P I C A assure la publication :

- - d'articles originaux se rapportant &

I'endoscopie dans ses applications m~- dicales et chirurgicales ;

- - de bancs d'essai de materiel e n d o - scopique ;

- - d'analyses bibliographiques.

A C T A E N D O S C O P I C A int6resse :

les Gastroent6rologues,

Gynecologues, O.R.L., Pneumologues, Urologues, Anato- mopathologistes,

Chirurgiens, Echogra- phistes, Radiologues, V~terinaires et tout Medecin ou Technicien curieux de

rendo- scopie.

A C T A E N D O S C O P I C A p u b l i s h e s :

-- original articles concerning e n d o s c o p y in its medical and surgical applications ; - - experimental studies of endoscopic ins-

trumentations ; - - bibliographical analysis.

A C T A E N D O S C O P I C A is p u b l i s h e d f o r :

Gastroenterologists, Gynecologists, E.N. T., Pneumologists, Urologists, Anatomopatho- Iogists, Surgeons, Echographists, Radio- logists, Veterinaries and all Physicians interested by endoscopy.

E d i t o r i a l

T h e 18 th Intensive European Course o f Digestive Endoscopy is going to take place in Strasburg. The concept o f the Course is refurbishing, although the main objectives are kept in line : 1) provide gastroenterologists with practical and high quality training in endoscopy and other imaging modalities in a diverse and multidisciplinary perspective ; 2) discuss not only the medical but also the practical and technical aspects o f endoscopy ; 3) focus on the newest techniques and advances, without overlooking those established ones that we daily use ; 4) support a fruitful exchange at a European level.

The programme is ambitious but our venerable Society - it was f o u n d e d in March 12 th, 2005 and is the oldest European Endoscopic Society, isn't it ? - has successfully taken over the challenge over years, as shown by the numerous and staunch attendance. The success o f the Course has been largely the result o f the restless involvement o f G~rard G A Y to organize it, design the p r o g r a m m e f o l l o w i n g suggestions made by the B o a r d and maintain the E u r o p e a n dimension. A t the time GOrard is going to pass the handkerchief, let me thank him warmly for his action, on behalf o f the Board members and the numerous attendees o f the Course. He could raise the scientific quality o f the meeting, preserve its European dimension, as shown by the Course location in Strasburg and maintain its friendly organisation.

The future challenge for S M I E R seems as huge as was its success in the past.

The Board must progressively be renewed with younger colleagues more and more involved in the design o f the programme, the m i n d turned to the newest advances. Involvement o f European colleagues must also increase in the near future. Maybe should English become the official language o f the Course or a simultaneous translation could be proposed, the reason why it was not yet set up being only financial. Thereby, the Course could open to gastroenterologists f r o m all European countries, including Eastern Europe. The trend to favour multidisciplinary approaches should also be encouraged with an increased participation of radiologists, surgeons, pathologists'...

Post-graduate medical education will become an actual challenge over the next f e w years' and the Intensive European Course o f Digestive Endoscopy is expected to play an important role and be a c k n o w l e d g e d by official C M E credits. The S M I E R is" not willing to compete with organisations like the French Society and the European Society f o r Digestive Endoscopy, which are sponsoring it, but to offer a c o m p l e m e n t a r y educational opportunity. The evolution o f practice and the European regulations will dramatically reinforce the impact o f C M E on our daily practice and the original programme o f the S M I E R Course will certainly be attractive in this frame.

The 18 th Intensive European Course o f Digestive Endoscopy launches a new formula, over two half-days, without loosing its originality. The programme is appealing, tackling the relationships o f endoscopy with surgery, pathology and radiology. Practical aspects have not been neglected with the role o f anaesthesia and the disinfection issues. We hope y o u will be numerous to attend the Course in Strasburg, because y o u r presence is the best warranty f o r its future development.

We would also like to thank all our partners in the organisation o f the Course, the pharmaceutical industry, endoscope and accessories manufactu- rers. Their contribution is crucial but their presence in the exhibit is also an important part o f the educational ground o f the meeting, as they present their newest material Aleou Organisation should also be acknowledged f o r the practical local organisation.

We hope that this 18th Intensive European Course o f Digestive Endoscopy will provide each o f you a valuable scientific information that will help you to improve y o u r practice et constitnte an opportunity f o r fruitful personal contacts leading to an actual European cooperation.

Welcome to Strasburg/

M. D E L V A U X

Acta Endoscopica

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