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Biomedical subjects

H Bismuth

Publications and source records attributed to H Bismuth.

At least 415 records · Page 23Linked to original sources
PubMed1981

[Diagnostic value of selective angiography in the pancreatic affections (author's transl)].

A retrospective study of selective angiography of the coeliac axis and superior mesenteric artery was conducted in 60 patients having a pancreatic disease. The purpose of this study was to precise the frequency, the specificity and the diagnostic value of each radiological sign in malignant and non malignant pancreatic affection. In patients with cancer of pancreas, the best radiological sign are the presence of an arterial obstruction, an irregular arterial stenosis, a venous obstruction or a parenchymal hypervascularization. In patients with benign affections, the most significant signs are á regular arterial stenosis alore or associated with an arterial involvement or the association of at least two of the three following signs: regular arterial stenosis, arterial involvement and venous compression. Using this signs, a correct diagnosis can be done, a posteriori, in 82% of the malignant pancreatic affections and in 76% of the benign pancreatic disease.

Arteries↗
PubMed1980

Heterotopic liver transplantation in end-stage HBsAg-positive cirrhosis.

A patient with end-stage cirrhosis complicating HBsAg-positive chronic active hepatitis given a heterotopic liver transplant is alive and well 28 months after transplantation; liver function is normal, and there are no hepatitis-B related lesions on the liver graft despite positivity of HBsAg in the serum. This observation confirms that a heterotopic liver graft can offer long-term survival in man and suggests that this technique may be a more suitable procedure than orthotopic transplantation in end-stage cirrhotics.

Child, Preschool↗
PubMed1980

Preoperative evaluation of the risk of common bile duct stones.

The patient with gallstones has an unknown risk of also having choledocholithiasis. To establish this risk preoperatively, several tests were studied in 167 patients, 37 of whom had common duct stones at exploration. With no previous or current jaundice, as well as normal alkaline phosphatase levels and a duct size of less than 12 mm, there was less than a 5% risk of choledocholithiasis; elevated bilirubin and/or alkaline phosphatase levels indicated intermediate risks (33% to 66%); and a duct size of 12 mm or greater, with any combination of other factors, indicated a 90% to 100% risk of choledocholithiasis. The surgeon should be aware of these probabilities in evaluating conditions of patients with cholelithiasis.

Alkaline Phosphatase↗
PubMed1980

Portal diversion for portal hypertension in children. The first ninety patients.

Ninety children with portal hypertension were treated by portal diversion. Fifty-two had cavernous transformation of the portal vein and 38 had an intrahepatic block from various causes. There were 59 central splenorenal shunts, 19 mesocaval, 11 portacaval and one distal splenorenal. In 61 peripheral shunts the veins used for the anastomosis were less than 10 mm in diameter. There was no operative mortality in children with extrahepatic block. One child with cystic fibrosis died postoperatively. Thrombosis of the shunt occurred in five children (5.6 per cent) and was responsible for recurrent bleeding in two. Four children with a thrombosed shunt underwent succesful reoperation and one is awaiting another anastomosis. No late complications occurred in the 52 children with extrahepatic block, while encephalopathy developed in four children with intrahepatic block. These figures confirm our earlier results in the management of portal hypertension in childhood and suggest that portal diversion is the treatment of choice. Several precautions have permitted lowering of the rate of thrombosis whichever shunt is performed. Portal diversion should be indicated following the first episode of hemorrhage in children with extrahepatic block. In patients with intrahepatic block, congenital hepatic fibrosis and cystic fibrosis are good indications as are in general the hepatic diseases with no or mild activity.

Adolescent↗
PubMed1980

Criteria for hepatic transplantation in cirrhosis.

Among the patients considered for hepatic transplantation, cirrhosis should be theoretically the best indication. Results so far are disappointing because the patients who have undergone a transplantation had end stage liver disease. When gastrointestinal bleeding, renal failure, coagulopathy and encephalopathy are used as criteria, one can accurately select patients who will die from cirrhosis within one month. Our results for those who had a liver graft in this group are poor. Criteria were then selected to identify a less dramatically ill group of patients with cirrhosis. These patients have residual poor liver function after surviving acute severe complications and have a spontaneous survival of less than one year. The results of liver transplantation in two patients in this group are encouraging.

Adult↗
PubMed1980

[Experimental hepatic encephalopathy. Study of the organization of a diurnal sleep pattern in rats with portocaval anastomosis].

The organization of the diurnal sleep pattern was studied in control rats and in rats with end-to-side portocaval shunt before operation and during five weeks after operation. In control rats, no modification of the states of sleep was observed during the experimentation. In shunted rats, the total duration of waking increased, the total duration of slow wave sleep and paradoxical sleep decreased. The number of phases of waking and slow wave sleep increased and the number of phases of paradoxical sleep decreased. The mean duration of the phases of slow wave sleep decreased. These results show that the electrophysiological expression of experimental hepatic encephalopathy is similar to the electroclinical expression of hepatic encephalopathy in man and the polygraphic study of sleep disturbances permits the description of the encephalopathies.

Animals↗
PubMed1979

Portal hypertension after bile duct obstruction: effect of bile diversion on portal pressure in the rat.

Biliary obstruction of 14 and 28 days induced in the rat an increase of portal pressure (PP) and wedge hepatic vein pressure (WHVP); the higher these were, the longer was the obstruction. Occurrence of portal hypertension seemed related to portal and periportal fibrosis. Relief of obstruction after 14 days by bilioduodenal anastomosis brought back to normal PP and WHVP. In rats with longer obstruction periods, bilioduodenal anastomosis failed to lower PP and WHPV although biological signs of cholestasis returned to normal levels. These results suggest that portal hypertension may arise very shortly after biliary obstruction in rats and that it may persist in animals with a prolonged biliary obstruction despite an efficient bile drainage. In clinical conditions, such results would favor early treatment of lesions that usually cause prolonged bile duct obstruction, such as postoperative bile duct stenosis.

Animals↗
PubMed1979

Emergency hepatic arterial embolization for secondary hypercalcemia in hepatocellular carcinoma.

Two successive hepatic arterial embolizations were performed in a patient with hypercalcemia secondary to hepatocellular carcinoma. The first procedure was performed on an emergency basis due to a cardiovascular episode and was immediately beneficial. The second procedure, performed five months later for a recurrence, was effective in 3 days; 13 months later, there had been no recurrence.

Carcinoma, Hepatocellular↗