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Hepatic [14C]aminopyrine demethylation capacity after portocaval shunting. Comparative study in patients with and without arterialization of portal vein.

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Horsmans, Yves [UCL] Lejeune, D. Geubel, André [UCL] Otte, Jean-Bernard [UCL] Pauwels, Stanislas [UCL]

The [14C]aminopyrine breath test (ABT) was used before and after surgical portocaval shunting in 29 cirrhotic patients, 15 with arterialization of the portal vein and 14 without. These two subgroups were comparable with regard to age, prothrombin time, serum albumin, serum total bilirubin concentrations, Child classification, and preoperative ABT. After portocaval shunt, a striking reduction in ABT values was observed after 6 and 12 months (90.7 +/- 8.0%, P < 0.05 and 77.3 +/- 7.5%, P < 0.005, respectively). No further decrease was observed between 12 and 24 months. The microsomal function was reduced to a greater extent in patients with postnecrotic cirrhosis (55 +/- 4.8%, P < 0.01) than in those with alcoholic cirrhosis (84.8 +/- 10.4%, P < 0.05). Arterialization of the portal stump of the portal vein did not prevent the reduction in hepatocellular function. No significant change in prothrombin time, serum albumin, or bilirubin concentrations was observed during the follow-up period in any of the groups. Overall, preoperative ABT was significantly higher in those surviving one year (0.29 +/- 0.12% administered dose) than in those who died within this time period (0.12 +/- 0.01%, P < 0.005). This observation suggests that portocaval anastomosis induces an early decrease in microsomal function that is not prevented by arterialization of the portal vein. It also suggests that ABT might be helpful in selecting patients for shunt surgery.

Document type Article de périodique (Journal article) – Comparative Study, Journal Article
Access type Accès restreint
Publication date 1993
Journal information "Digestive diseases and sciences" - Vol. 38, no. 12, p. 2177-82 (1993)
Peer reviewed yes
issn 0163-2116
Publication status Publié
Affiliations UCL - MD/MINT - Département de médecine interne
UCL - MD/CHIR - Département de chirurgie
MESH Subject Adult ; Aged ; Aminopyrine - analysis ; Breath Tests ; Carbon Radioisotopes - diagnostic use ; Esophageal and Gastric Varices - complications - surgery ; Female ; Follow-Up Studies ; Gastrointestinal Hemorrhage - complications - surgery ; Humans ; Liver - blood supply - metabolism - physiopathology ; Liver Cirrhosis - complications - physiopathology ; Male ; Methylation ; Middle Aged ; Portacaval Shunt, Surgical ; Portal Vein - surgery ; Prognosis
Links
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Bibliographic reference Horsmans, Yves ; Lejeune, D. ; Geubel, André ; Otte, Jean-Bernard ; Pauwels, Stanislas. Hepatic [14C]aminopyrine demethylation capacity after portocaval shunting. Comparative study in patients with and without arterialization of portal vein.. In: Digestive diseases and sciences, Vol. 38, no. 12, p. 2177-82 (1993)
Permanent URL http://hdl.handle.net/2078.1/23044