Definitive Preoperative Diagnosis of Obstructive Jaundice

Carbohydrate Tolerance and Insulin Responses in Obstructive Jaundice

“…Delayed absorption of glucose as well as a nonspecific effect of jaundice on carbohydrate tolerance (Berkowitz et al, 1966) must also be considered in explaining the high proportion of abnormal results. In previous work (Murphy and Smith, 1963;Braganza and Howat, 1972) a high prevalence of diabetic responses to G.T.T.s was reported in patients with carcinoma of the pancreas but it was not made clear whether patients were already jaun-diced when investigated. Our study suggests that patients with obstructive jaundice from causes other than carcinoma of the pancreas are just as likely to have a diabetic response to the G.T.T.…”

“…Gall stones and carcinoma of the pancreas account for most cases but various other conditions such as drug-induced cholestasis or hepatitis may be responsible. Abnormal glucose tolerance has -been reported in 37% to 50% of patients with carcinoma of the pancreas (Murphy and Smith, 1963;Braganza and Howat, 1972) while other -workers have shown a flat insulin response to glucose (McKiddie et at., 1969). According to Malins (1968) and Truelove and Reynell (1972) glycosuria and an albnormal glucose tolerance in a patient with obstructi:ve jaundice favour a diagnosis of carcinoma of the pancreas.…”

Intra-Arterial Chemotherapy for Patients with Inoperable Carcinoma of the Pancreas

“…Jaundice can be relieved by surgical intervention and this will increase the length of survival of patients. However, pain occurs at some time during the course of the illness in 80 % -of patients and, when it occurs at an early stage of the disease, it persists not only as a major symptom but as an ominous sign (Braganza & Howat 1972). The use of intra-arterial chemotherapy primarily for the relief of pain has been explored in this neoplasm and those of the liver, biliary tree and gall-bladder.…”