cholecystokinin and Jaundice

Topics: Abdomen; Biopsy; Carcinoma, Intraductal, Noninfiltrating; Celiac Disease; Cholecystokinin; Diabetes Mellitus; Hepatomegaly; Humans; Jaundice; Laparotomy; Mental Disorders; Pain; Palliative Care; Pancreatectomy; Pancreatic Neoplasms; Prednisolone; Prognosis; Radioisotopes; Radionuclide Imaging; Secretin; Selenium

Topics: Age Factors; Amylases; Angiography; Cholecystokinin; Colic; Diabetes Complications; Diagnosis, Differential; Emaciation; Germany, West; Humans; Jaundice; Pancreatic Cyst; Pancreatic Neoplasms; Pancreatitis; Portography; Secretin

We undertook to test the recent suggestion that measurement of immunoreactive carcinoembryonic antigen (CEA) in pancreatic secretion may be useful in diagnosis of pancreatic cancer. Using duodenal intubation and a perfusion method in 57 cases, we measured the rate of pancreatic CEA secretion into the duodenum under basal saline perfusion, alone and with continuous intravenous infusion of secretin (2 clinical units per kg per hr) and of cholecystokinin-pancreozymin (CCK, 15 Crick-Harper-Raper units per kg per hr); and we compared the CEA output with secretion of trypsin, lipase, and bicarbonate under the same conditions. Subsequent laparotomy revealed pancreatic carcinoma in 25 patients, pancreatitis in 7, other intraabdominal malignancies in 6, and benign nonpancreatic disorders in 19. CEA output rates did not differentiate all pancreatic-cancer patients from other patients in any test condition. However, pancreatic enzyme outputs were abnormal with almost 90% of cancers of the pancreatic head and with 75% of cancers of the pancreatic body and tail. For detection of pancreatic cancer, enzyme and bicarbonate outputs in response to CCK are more accurate than pancreatic CEA or bicarbonate outputs in response to secretin. Since CCK-stimulated enzyme outputs can be related accurately to malabsorption (not reported here), we prefer them to bicarbonate output for assessment of pancreatic function.

Topics: Adult; Bicarbonates; Carcinoembryonic Antigen; Cholecystokinin; Humans; Jaundice; Lipase; Pancreas; Pancreatic Neoplasms; Trypsin

C-terminal octapeptide of cholecystokinin was administered at six dose levels, 4-128 ng/kg, by 184 intravenous injections to three mongrel dogs under several pressure conditions of the biliary system. Gallbladder contraction was monitored radiographically. A good, dose-dependent contraction response resulted with intraductal pressures of 0 and 10 cm water. At 20 cm water, a markedly reduced and dose-independent response occurred. No contraction response was found with an intraductal pressure of 30 cm water. This animal experimental work suggests that in man, a contraction response of 30% or more may rule out significant common bile duct obstruction.

Topics: Animals; Biliary Tract Diseases; Catheterization; Cholangiography; Cholecystography; Cholecystokinin; Cholestasis; Common Bile Duct; Diagnosis, Differential; Dogs; Gallbladder; Injections, Intravenous; Jaundice; Pressure

The uptake of (75)Se Selenomethionine by the pancreas has been evaluated in 102 patients and compared with the secretin-pancreozymin test of pancreatic function. In groups of patients with chronic pancreatitis and cancer of the pancreas abnormal scans closely parallel the diminished exocrine secretion, especially bicarbonate output, following a submaximal dose of secretin. Thirty per cent of the group with no pancreatic abnormality have abnormal scans, though the secretinpancreozymin test is normal. Though a normal scan excludes the presence of chronic pancreatitis and cancer of the pancreas with a probability greater than 90%, an abnormal scan is found so frequently in normal subjects that it does not provide a reliable index of impaired pancreatic function.

Topics: Bicarbonates; Celiac Disease; Cholecystokinin; Chronic Disease; Humans; Jaundice; Liver Cirrhosis; Liver Cirrhosis, Biliary; Methionine; Pancreas; Pancreatic Neoplasms; Pancreatitis; Radionuclide Imaging; Secretin; Selenium

Topics: Acute Disease; Adult; Ampulla of Vater; Cholecystectomy; Cholecystokinin; Chronic Disease; Female; Gastroenterostomy; Humans; Jaundice; Male; Methods; Pancreatitis

Topics: Cholecystokinin; Diagnosis, Differential; Humans; Jaundice; Secretin; Sulfobromophthalein

Topics: Acute Disease; Cholecystokinin; Gallbladder; Hepatitis A; Humans; Jaundice

Topics: Alcoholism; Amylases; Anemia, Hemolytic; Cholecystokinin; Chymotrypsin; Clinical Enzyme Tests; Fatty Liver; Humans; Hyperlipidemias; Jaundice; Pancreas; Secretin; Trypsin