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Biomedical subjects

H Bismuth

Publications and source records attributed to H Bismuth.

At least 397 records · Page 22Linked to original sources
PubMed1983

Microlithiasis of the gallbladder.

Patients with microlithiasis represent a small group compared with the general population of patients with gallstones. However, it is a group which deserves particular attention because of the risk of acute pancreatitis. For this reason, cholecystectomy should be advocated in patients considered to be at low anesthetic risk in which echography or roentgenography detects the presence of minute stones in the gallbladder, even in the absence of biliary disorders.

Acute Disease↗
PubMed1983

[Changes in hepatic blood flow after various types of portal shunt in the rat].

The relationship between liver trophicity and the early (24 h) or late (14 days) modifications of the hepatic blood flow were studied in the rat after several types of portosystemic shunts (portacaval shunt, mesocaval shunt, portacaval transposition and arterialization of the portal vein after portacaval shunt). Twenty-four hrs after portacaval shunt, the total hepatic blood flow was decreased to 60 p. 100 of the initial value and remained so during the following days. Within a week, there was a liver atrophy with a decrease of the LW/BW to 60 p. 100 of the preoperative value. Fourteen days after operation, the hepatic blood flow per gram of liver was similar to that observed preoperatively. Whatever the type of shunt, there was a significant relationship between total hepatic blood flow and liver weight, 14 days after operation. Thus, after portal diversion, the quality of the blood perfusing the liver has little incidence upon the maintenance of liver trophicity. These results suggest that hemodynamic factors are more important than hormonal (pancreatic) factors in the constitution of liver atrophy after end-to-side portacaval shunt.

Animals↗
PubMed1982

Surgically induced acute hepatic failure in the rat.

Several surgical procedures were tested in the rat in order to create a spontaneously lethal but potentially reversible acute hepatic failure. Two combined surgical procedures fulfill these conditions: '75% hepatectomy' plus portacaval shunt and '85% hepatectomy' plus 30-min clamping of the celiac and superior mesenteric arteries. These two procedures should constitute useful tools for the evaluation of new methods of hepatic support.

Animals↗
PubMed1982

Liver atrophy and encephalopathy after portacaval shunt in the rat.

The effect of various types of portal diversion (portacaval, mesocaval and pancreatico-splenocaval anastomoses, portacaval transposition and arterialization) on liver atrophy and post-shunt encephalopathy was studied in the rat. Among all diversions, only portacaval anastomosis produced dramatic liver atrophy and encephalopathy. Moreover, portacaval anastomosis was also the only portal diversion which induced low body weight gain. There was no correlation between blood ammonia levels and encephalopathy. Liver atrophy was always correlated to a decrease of hepatic blood flow. Diminution of liver blood flow was only slight following partial (either mesenteric or pancreatico-splenic) diversion of portal blood and nil after portacaval transposition or anastomosis. These results suggest that: (1) pancreatic (insulin-rich) blood is not essential for maintenance of liver trophicity. Hemodynamic factors seem to be predominant in the pathogenesis of post-shunt liver atrophy. (2) Post-shunt encephalopathy arises only when total diversion of the portal blood and liver atrophy are associated.

Ammonia↗
PubMed1982

Treatment of postshunt encephalopathy with secondary arterialization: an experimental study in the rat.

Secondary arterialization of the hepatic stump of the portal vein has been performed in rats 7 days after portacaval anastomosis (PCA) at a date when the electrocorticographic changes of postshunt encephalopathy were evident. A complete regression of encephalopathy ensued. This correlated with an increase in the weight of the liver and estimated hepatic blood flow. These results confirm the efficiency of liver arterialization, primary or secondary, in the treatment of postshunt encephalopathy. In the groups of rats studied in this experiment a significant correlation was always found among encephalopathy, liver weight: body weight ratio, and hepatic blood flow. This reinforces the hypothesis that a decrease in hepatic blood flow is the main factor in the generation of liver atrophy, decrease of hepatic function, and encephalopathy following portacaval shunt. Primary arterialization of the liver in humans has not gained much favor because of technical difficulties, a high mortality rate, and the absence of clear-cut evidence of its efficiency. Our results suggest that arterialization of the liver might better be kept as a secondary procedure for those cases in which encephalopathy develops after PCA.

Animals↗
PubMed1981

Enhancement of Aflatoxin B1 induced liver carcinogenesis by portal diversion in the rat.

Conflicting results have been reported on the influence of portacaval anastomosis on liver carcinogenesis. The purpose of this investigation was to study the effect of portal diversion on liver carcinogenesis induced in the rat by a potent chemical liver carcinogen, Aflatoxin B1 (AFB1). Liver tumors appeared earlier and were significantly bigger in rats with shunts than in sham-operated controls. Portal diversion also induced in rats fed AFB1 a splenic atrophy with nearly complete disappearance of Malpighian corpuscles suggesting a profound immunodepression. This might be responsible for the enhancement of liver cancer by portacaval anastomosis in the rats fed AFB1. Thus, the influence of portal diversion on liver cancers appears to be multifactorial.

Aflatoxin B1↗