-
[show abstract]
[hide abstract]
ABSTRACT: A comparative study of alpha-fetoprotein (AFP) and carcinoembryonic antigen (CEA) in serum was made by radioimmunoassay in 66 patients with pancreatobiliary disease with and without obstructive jaundice. biliary concentrations of these proteins were assayed in 12 patients with benign and 7 patients with malignant disease. There was no statistical difference in serum AFP between these two groups but there was a difference in serum CEA. Although CEA and AFP in bile in both groups were higher than in serum there was no statistical difference in serum CEA and AFP in patients with and without obstructive jaundice in either benign or malignant disease. In benign disease, patients with inflammation had higher serum CEA than normal. Although there was no statistical difference in serum CEA in patients with a without liver metastases, the serum CEA in liver metastases was significantly higher than in benign disease. We concluded that AFP is unlikely to be important in the assessment or management of patients with cancers other than those derived from the liver or yolk sac, and that the elevation of serum CEA in patients with malignant pancreatobiliary disease either with or without obstructive jaundice occurs mainly in the presence of widespread malignancy, especially in liver metastases.
Journal of Surgical Oncology 04/1982; 19(4):228-32. · 2.10 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Endoscopic retrograde cholangiography, percutaneous transhepatic cholangiography with external bile drainage and a combined method utilizing both procedures were evaluated in 187 patients with obstructive jaundice. Ductal obstructive regions were located in 90 per cent of cases by endoscopic retrograde cholangiography, and 55 per cent of these were correctly diagnosed. Complications were observed in 7.9 per cent with a mortality rate of 2.9 per cent. The most serious complication was cholangitic sepsis. By percutaneous transhepatic cholangiography with external bile drainage, ductal obstructive regions were correctly located in 82 per cent, 37 per cent of these patients were correctly diagnosed. Complications occurred in 9.2 per cent with a mortality rate of 1.5 per cent. The most serious complication was massive bleeding. Successful external bile drainage could be obtained in most cases. The combined method overcomes the disadvantages of the single methods and the cause of obstructive jaundice can be diagnosed more precisely. The surgeon has a better knowledge of the type and the extent of the lesion prior to definitive surgery and can operate more safely on patients with obstructive jaundiced when the serum total bilirubin, has decreased to a level below 5 mg/dl.
The American surgeon 10/1981; 47(9):387-92. · 1.28 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: A new contrast medium has been used for endoscopic pancreatography. Good visualization of the pancreas was obtained by this method. No side-effects of this method were observed by clinical and histologic examination, either in clinical or experimental studies. Clinically, the new method provided more detailed information regarding pancreatic changes in chronic pancreatitis. It is suggested that this method may make detection of a small tumor of the pancreas in the parenchyma and permit earlier diagnosis of carcinoma of the pancreas.
Surgery, gynecology & obstetrics 03/1980; 150(2):198-202.
-
[show abstract]
[hide abstract]
ABSTRACT: A patient with massive pancreatic pleural effusion in whom the use of endoscopic retrograde cholangiopancreatography (ERCP) revealed the site of a pancreatic fistula to the pleural cavity is presented. It is suggested that with this form of pleural effusion, ERCP may aid in the selection of those patients whose lesions may be surgically correctable.
The American Journal of Surgery 10/1978; 136(3):390-2. · 2.78 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Retrograde pancreatocholangiography was successful in 110 or 83 per cent of 133 patients suspected of having pancreatobiliary disease. Cannulation of the pancreatic duct was successful in 95 per cent of the patients suspected of having disorders of the pancreas. In 84 per cent, the biliary tree was successfully visualized among the group suspected of having disorders of the biliary tract. Dilatation of the main pancreatic duct in association with cholelithiasis and choledocholithiasis was observed in 33 and 72 percent, respectively.
Surgery, gynecology & obstetrics 04/1975; 140(3):349-54.
