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Biomedical subjects

J Papp

Publications and source records attributed to J Papp.

At least 55 records · Page 3Linked to original sources
PubMed1985

Pancreatic function after endoscopic and surgical occlusion of the pancreatic duct in patients with chronic pancreatitis.

Complex monitoring of pancreatic function was done after 18 endoscopic or surgical occlusions of the pancreatic duct in 15 patients with chronic pancreatitis. The indirect function tests (starch tolerance test, Lipiodol test and fat loading) as well as the direct tests (secretin-pancreozymin and Lundh tests) demonstrated only moderate pancreatic insufficiency. Overall values of the Lundh test performed before and after the treatment in 10 cases did not change significantly. The surgical procedure decreased pancreatic function somewhat more effectively, but the symptom-free "burned-out" state was only rarely achieved. Even glucose tolerance slightly diminished after treatment. The uneven results of obstruction therapy were attributed to the recovered exocrine function of the pancreas. Patients with severe pancreatic insufficiency or proximal resection of the pancreas seem to be better candidates for such treatments.

Chronic Disease↗
PubMed1985

[Endoscopic occlusion treatment in patients with chronic pancreatitis].

Between 1980 and 1983 an endoscopic occlusion of pancreatic duct was performed in 12 patients with chronic pancreatitis. In 4 patients it could be achieved a complete, in 8 patients only a partial occlusion. Four patients became free of pain whereas 5 patients have been operated on following an aggrevation of disease. After one year diabetes mellitus developed in 2 patients. We conclude that the endoscopic occlusion of the pancreatic duct may be recommended in some patients with defined diagnosis and special duct constellation.

Adult↗
PubMed1985

[Endoscopy of the bile ducts and pancreas in children].

ERCP was carried out in 8 children under 14 years age. The indications of examinations were in 7 cases obstructive jaundice caused in 3 patients by congenital anomalies of the biliary tract. In one case the ERCP was performed because of acute relapsing pancreatitis. The examinations were carried out under general anesthesia in 5 children and after sedative premedication in 3 cases. No complications of the procedures were recorded. ERCP is a useful method also in children for diagnosing bilio-pancreatic anomalies.

Acute Disease↗
PubMed1982

[Effect of somatostatin on metabolic changes following ERCP ].

An investigation was carried out on the ameliorating effect of cyclic somatostatin on the biochemical changes and impairment of glucose tolerance which follow endoscopic retrograde pancreatography. Serum amylase and plasma insulin and glucagon levels were significantly lower in a group of 20 patients receiving somatostatin prior to pancreatic radiography than in 35 control patients without such pretreatment. (Maximum increases in control and somatostatin-pretreated patients, respectively were: amylase: 4695 +/- 290; 1037 +/- 155 U/l p less than 0.001; insulin: 504 +/- 89; 179 +/- 43 pmol/l p less than 0.001; glucagon: 394 +/- 44; 62 +/- 13 pmol/l p less than 0.05.) Impairment of glucose tolerance was also considerably less in the patients given prophylactic somatostatin. These results indicate that postpancreatographic metabolic abnormalities can be ameliorated, or possibly even prevented altogether, by prior administration of somatostatin.

Amylases↗
PubMed1982

[A case of congenital cystic intrahepatic bile duct dilatation (Caroli syndrome) treated with hepato-lobectomy].

The authors report a successful hepatolobectomy of Caroli's disease (segmentally dilatated intrahepatic bile ducts). They also give a survey of congenital and acquired bile duct dilatations, with a view to differential diagnosis and medical treatment. When Caroli's disease is suspected, echography and ERCP can be a valuable diagnostic aid. The definitive cure i. e. the elimination of the anatomical basis of recidive cholangitis, can only be achieved by the resection of the liver containing the dilated intrahepatic bile ducts. Postoperative administration of antibiotics and anticholelithic drugs can help the liver to full recovery.

Bile Ducts, Intrahepatic↗
PubMed1981

[Postcholecystectomy syndrome: endoscopic and radiological aspects (author's transl)].

542 patients were subjected to ERCP at various periods after cholecystectomy. In this selected patient material there was a 56% incidence of morphological abnormalities in the biliary system, stenosis of the papilla and choledocholithiasis being the most frequent pathological findings. Laboratory examinations proved to be irrelevant with respect to the morphology of the bile ducts. A direct relationship between the clinical symptoms and the surgical procedure was established only in cases presenting with biliary duct stenosis (11% of all cases examined). In the majority of patients the postcholecystectomy complaints were due to incorrect surgical indication or inadequate surgical technique. Postcholecystectomy syndrome can be prevented by more accurate evaluation of the patient prior to and during surgery.

Adult↗
PubMed1981

Changes in glucose tolerance after endoscopic retrograde cholangiopancreatography.

Changes in oral glucose-tolerance have been studied in patients subjected to endoscopic retrograde pancreatography. Glucose tolerance is impaired 72 hours after ductography, and significant changes can still be seen even after one month; glucose tolerance returns to normal six to 12 months after pancreatography. In an attempt to discover the mechanism underlying impaired tolerance serial measurements were made of plasma insulin and glucagon levels. The observation that the ratio I/G decreased in these patients indicates that enhanced glucagon release, probably due to mechanical and/or osmotic injury, may be responsible for the hyperglycaemia that is observed.

Amylases↗
PubMed1981

[Differential diagnostic possibilities of the liver and bile duct cysts (author's transl)].

The authors examined the diagnostical possibilities of the liver and bile duct cysts with different origin. On the base of the literature and own experiences surveyed the specific signs and the diagnostic value of peritoneoscopy, liver biopsy, scintigraphy, angiography, gray-scale ultrasonography, ERCP and PTC in the hepato-biliary cysts. GSU is the most suitable method to demonstrate the cystous character, but the connection with the biliary tract can be verified by ERCP. Peritoneoscopy is the best procedure in the diagnosis of the polycystic liver; the congenital liver fibrosis can be recognized by biopsy, only. The hepato-biliary cysts can be separated preoperative with the parallel adoption of these methods, in the majority of cases.

Bile Duct Diseases↗
PubMed1981

[The pathological endoscopic pancreatogram diagnostic value of radiomorphological changes (author's transl)].

The specificity of abnormal radiomorphological patterns in the endoscopic retrograde pancreatogram (ERCP) has been studied. Out of 3,000 ERCPs 381 contained pathological findings in the pancreatic duct, all of which was subsequently checked by histology. Comparison of the radiomorphologic data and the histologic abnormalities has revealed that ductal abnormalities are not specific to the underlying pancreatic disease. There are, however, changes in the radiomorphologic appearance which, owing to their greater incidence, may be regarded as characteristic to some pathologic process. Solitary stenosis or complete obstruction indicate the presence of tumour, nonsegmental extended dilatation points to papillary stenosis, filling of cavities reveals cysts, while diffuse abnormalities occur most frequently in chronic pancreatitis. Opacification of the bile ducts may yield complementary data, although their specificity is not absolute either. Nonsegmental stenosis of the intrapancreatic bile duct indicate chronic inflammation, while irregular narrowing supports the diagnosis of pancreatic tumours. Arc-shaped dislocation of the bile duct is frequently observed in response to cysts, stenosis confined to the ampullary segment and associated with dilated biliary system are characteristic findings in papillary stenosis. Thus the diagnostic value of the abnormal pancreatogram may be enhanced by simultaneous study of the biliary morphology

Cholangiopancreatography, Endoscopic Retrograde↗