The Role of Glucagon in the Treatment of Biliary Tract Pathology

Paul, F.

doi:10.1007/978-94-009-9212-2_9

Cited by 12 publications

(4 citation statements)

References 18 publications

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“…The choleretic effect of glucagon increases the rate of bile flow by up to 50 per cent (9, 10) and that, together with the effect of lowering the choledochoduodenal resistance, might encourage stones that have entered the common bile duct to pass into the duodenum. In a previously reported uncontrolled trial of glucagon in the management of abdominal pain due to cholelithiasis, pain relief was said to occur in under 5 min (6). In our study great care was taken to record the time at which the patient was totally pain free; such a rapid relief of pain was n o t seen in any of our patients.…”

Section: Discussionmentioning

confidence: 76%

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A trial of glucagon in the treatment of painful biliary tract disease

Stower

Foster

Hardcastle

1982

Journal of British Surgery

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Seventy-one patients with a clinical diagnosis of painful biliary tract disease have been entered into a double-blind trial of glucagon. Twenty-eight were excluded as gallstones were not proved: of the remainder, 21 patients received glucagon and 22 placebo. Glucagon-treated patients were pain free 14.26 h (+/- 2.77 s.e.m.) after commencing treatment compared to 29.14 h (+/- 6.01 s.e.m.) for the placebo group (P less than 0.05). Tenderness in the right hypochondrium showed a significant improvement when assessed at 12 h (P less than 0.02) and 24 h (P less than 0.1) for those given glucagon. A significant difference in blood glucose levels was seen between the two groups (P less than 0.05). No serious side effects were observed. Glucagon relieves the pain and tenderness associated with painful biliary tract disease more effectively than conventional therapy.

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Section: Discussionmentioning

confidence: 76%

“…Little attention has been paid to the use of glucagon in the management of acute cholecystitis or biliary colic. In the one uncontrolled trial that has been reported, a single intravenous injection of 0.2-1 mg glucagon was given to 31 patients which resulted in pain relief within 20 s to 5 min in 84 per cent of the patients (6).…”

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confidence: 99%

A trial of glucagon in the treatment of painful biliary tract disease

Stower

Foster

Hardcastle

1982

Journal of British Surgery

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“…Glucagon has been utilised as a therapeutic agent in clinical medicine and as a diagnostic aid in clinical radiology (Paul, 1979;Stower etal., 1982).…”

Section: Discussionmentioning

confidence: 99%

“…However, the smooth muscle relaxant properties of glucagon have only relatively recently been utilised in clinical medicine. Therapeutic studies have centred mainly on the treatment of biliary tract disease when intravenous glucagon was found to be effective in relieving pain and cystic duct obstruction (Paul, 1979;Stower et al, 1982 Figure 1 Glucagon:glucagon-(1-21)-peptide structure. Boxed area represents the 8 amino acids cleaved from glucagon to obtain glucagon-(1-21)-peptide.…”

Section: Introductionmentioning

confidence: 99%

The metabolic response to glucagon and glucagon‐(1‐21)‐peptide in normal subjects and non insulin dependent diabetics.

Owens¹,

Vora²,

Morris³

et al. 1986

Brit J Clinical Pharma

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1 The metabolic effects of glucagon leading to hyperglycaemia are well recognised. However, the spasmolytic properties of glucagon have only relatively recently been utilised in clinical medicine. 2 The marked hyperglycaemia accompanying the smooth muscle relaxant action of glucagon has led to the development of smaller peptides derived from glucagon which may retain the spasmolytic effects without the metabolic consequences. 3 This study compares the metabolic and hormonal response to one such peptide, glucagon-(1-21)-peptide, with the parent peptide glucagon. 4 The results demonstrate that glucagon-(1-21)-peptide has no metabolic effects comparable to glucagon. 5In normal subjects and non-insulin dependent diabetics, glucagon-(1-21)-peptide has no stimulatory effect on the pancreatic P-cell.

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Endoscopic sphincterotomy for retained common bile duct stones in patients with T-tube in situ in the early postoperative period

O'Doherty

Neoptolemos

Carr‐Locke

1986

Journal of British Surgery

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We report on thirty-nine patients who underwent endoscopic sphincterotomy (ES) and stone extraction for retained common bile duct calculi with a T-tube in situ. Sixteen of the patients had undergone unsuccessful attempts at removal by flushing or dissolution by cholesterol solvents. A total of 76 stones were present: 53 distal to the T-tube and 23 proximal to the T-tube. ES and clearance of the common bile duct was achieved in 37 patients (95 per cent) and complications occurred in three patients (7.7 per cent). This method is an effective and relatively safe method in the early postoperative period allowing rapid treatment during the same admission as for the original operation and early hospital discharge.

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The Role of Glucagon in the Treatment of Biliary Tract Pathology

Cited by 12 publications

References 18 publications

A trial of glucagon in the treatment of painful biliary tract disease

A trial of glucagon in the treatment of painful biliary tract disease

The metabolic response to glucagon and glucagon‐(1‐21)‐peptide in normal subjects and non insulin dependent diabetics.

Endoscopic sphincterotomy for retained common bile duct stones in patients with T-tube in situ in the early postoperative period

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