Search PubMed⌕ Search

Biomedical subjects

H Bismuth

Publications and source records attributed to H Bismuth.

At least 451 records · Page 25Linked to original sources
PubMed1975

[Digestive tract hemorrhages of cirrhotic patients. Relation between hepatic insufficiency and the hemorrhagic lesion].

The cause of upper gastrointestinal bleeding was studied in 85 cirrhotic patients by emergency endoscopy. In every patient, one or several lesions were observed and the site of bleeding was ascertained in 59. The two main causes were oesophago-gastric varices (46 p.cent) and acute mucosal lesions(42 p.cent). The source of bleeding appeared to be related to the degree of liver function impairment. In patients with no or moderate liver function impariment, bleeding usually originated from varices or from drug-associated mucosal erosions. Patients with severe impairment of liver function most often bled from spontaneous acute oeso-gastro-duodenal ulcerations. These ulcerations resembled what has been described in "stress" hemorrhage. Because of the relationship between liver function and the cause of hemorrhage, mortality was lower in variceal bleeders (29 p.cent) than in patients with spontaneous ulcerations (83 p.cent). In patients with severely impaired liver function, portacaval shunt was rarely indicated since hemorrhage was generally due to acute mucosal ulcerations.

Adult↗
PubMed1975

Electrocorticographic distrubances after portacaval shunt in the rat: a quantitative evaluation.

Electrocorticographic recordings were analyzed in two groups of Wistar rats with end-to-side portacaval shunt and sham portacaval shunt. The main electrical abnormalities observed in the shunted rats concerned slow wave sleep. Quantitative evaluation of these disturbances was made by measuring the duration of spindles normally present in this phase of sleep. Longer duration of the spindles appears to be a reliable index of electrocorticographic disorders after portacaval shunt in the rat.

Animals↗
PubMed1975

Biliobiliary fistula. A trap in the surgery of cholelithiasis.

Of 24 cases of abnormal communication between gallbladder and main bile duct occurring in a service specializing in hepatobiliary surgery, jaundice was present in all, but variable in degree and persistence. No particular clinical picture suggested this complication of cholelithiasis, and preoperative diagnosis is rare. At operation, adhesions were strikingly dense, often first suggesting a diagnosis of cancer. The gallbladder, fused to the main bile duct, should not be dissected from it because of the risk of ductal injury. Under these conditions, the gallbladder should be opened peripherally, stones extracted, and a cholangiogram performed to assess the situation. Treatment consists of partial cholecystectomy and closure of a cuff of gallbladder wall over a T tube placed into the main bile duct through the fistula.

Adult↗
PubMed1975

Cholangitis with acute renal failure: priorities in therapeutics.

Obstructive cholangitis with acute renal failure is a dramatic syndrome which merits individual definition. Twenty-one patients with acute suppurative cholangitis complicated by rapidly developing renal insufficiency were studied, and the severity of the renal failure, an acute interstitial tubulopathy, bore no significant relationship to the serum bilirubin level. The mechanism of renal damage was clearly related to episodes of septicemia. Increasing experience has modified the approach to treatment. The dominant septic problem can often be controlled by vigorous antibiotic and fluid therapy, allowing time for spontaneous improvements in renal function. All patients thus operated at a distance from the septic episode survived. If emergency operation is required because of persistent or recrudescnet sepsis, the necessity for dialysis should be considered first; the circumstances demanding dialysis are defined. The priorities in therapy are then: 1) treatment of the infection, 2) treatment of the renal failure, and finally 3) operation. The amount of the operation depends on the evolution of the sepsis, but should be preceded by dialysis when required.

Acute Kidney Injury↗
PubMed1975

Early recovery of albumin synthesis after liver transplantation.

The delay necessary for an orthotopic transplanted liver to recover in normal activity has never been defined. This is of great importance whenever liver transplantation is considered in patients with severe liver insufficiency. This delay was studied in dogs using albumin synthesis and BSP clearance as tests of liver function. Albumin synthesis was normal as early as 2 h following graft revascularization while BSP clearance was not yet normal by this time. It is suggested that transplanted livers will be rapidly able to corect metabolic disorders and above all coagulation problems in patients with terminal hepatic failure.

Albumins↗
PubMed1975

Intrahepatic cholangioenteric anastomosis in carcinoma of the hilus of the liver.

It is important to expand the indications for resection of tumors of the hilas, generally requiring associated hepatectomy, after careful search for metastases and biopsy of any suspicious areas makes this reasonable. One can justify such a procedure, representing a major stress and a considerable mortality rate, only if one is sure that all the tumor will be removed. If resection cannot be carried out, a unilateral intrahepatic cholangioenteric anastomosis with preference for the round ligament technique is an excellent procedure when properly applied. If a contraindication to a left sided anastomosis exists, particularly invasion of the left sided confluences, the anastomosis is made on the right to the duct of segment V. Study of the cholangiogram with attenion to the primary and secondary confluences directs a decision to perform a double anastomosis the ducts are not dilated or a poor quality anastomosis is all that can be achieved on one side and when secondary confluents are involved on both sides. The results of a variety of techniques emphasize the importance of the cholangiogram in choosing the location of an anastomosis and the role of invasion of primary and secondary conversions in choosing the technique. Many of thse patients are young and, even if no resection is possible, amy survive several years. A renewed sense of well being and prolongation of life are achievable goals even if the tumor cannot be removed. There is every reason to offer the maximum to these patients so that, if they muse eventually die, it will be from the tumor itself and not from its biliary complications.

Acute Kidney Injury↗
PubMed1975

Effect of phenobarbital in a case of extrahepatic cholestasis.

Phenobarbital was administered to a patient with extrahepatic biliary obstruction who was initially thought to have cholestatic hepatitis. On two occasions, administration of the drug was associated with a decrease of jaundice, pruritus, and serum bile acid levels. This strongly suggests that phenobarbital may be effective not only in intrahepatic cholestasis, as reported earlier, but also in extrahepatic obstruction, and therefore cannot be used for the differention of these two types of cholestasis.

Adult↗
PubMed1975

[Transhepatic embolization of oesophageal varices (author's transl)].

Embolization of the aeso-cardiotuberositary varices, by selective catheterization of the coronary vein of the stomach and the posterior gastrics, seems to be valuable palliative treatment in portal hypertension, owing to its relative innocuousness, inspite of a certain number of failures. It is carried out by transhepatic puncture of the portal system or catheterization of the umbilical vein.

Aged↗