Application of dyclonine hydrochloride gel to patients unsuitable for antispasmodic agents during endoscopic retrograde cholangiopancreatography
10.3760/cma.j.cn321463-20230908-00245
- VernacularTitle:盐酸达克罗宁胶浆用于内镜逆行胰胆管造影术中不适合解痉剂患者的探讨
- Author:
Shixue LI
1
;
Xiufen TANG
;
Binbin ZHANG
;
Shuqin LI
Author Information
1. 黑龙江省医院消化病院，哈尔滨 150001
- Keywords:
Cholangiopancreatography, endoscopic retrograde;
Peristalsis,duodenum;
Sphincter of Oddi;
Intubation, gastrointestinal;
Dyclonine hydrochloride gel
- From:
Chinese Journal of Digestive Endoscopy
2024;41(5):397-400
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the efficacy and safety of dyclonine hydrochloride gel for patients unsuitable for antispasmodic agents during endoscopic retrograde cholangiopancreatography(ERCP).Methods:A total of 72 patients diagnosed as having biliary diseases who intended to receive ERCP but were unsuitable for spasmolytic use were selected from June 2022 to June 2023 at the Digestive Hospital of Heilongjiang Provincial Hospital. Thus dyclonine hydrochloride gel was locally sprayed during the process of ERCP due to frequent intestinal peristalsis. The amplitude and frequency of duodenal peristalsis, clarity of endoscopic view, the time of biliary cannulation and vital signs were compared before and after the administration to evaluate efficacy and safety of dyclonine hydrochloride gel. At the same time, 9 patients with suspected sphincter of Oddi dysfunstion (SOD) underwent sphincter of Oddi manometry (SOM) before and after the administration.Results:Among the 72 patients, 57 (79.2%) showed improvements in duodenal peristalsis after the administration ( t=22.524, P<0.05). Twelve cases with significantly obstructed views due to bubbles showed complete improvement after the medication. The time for successful biliary cannulation after the administration was 2.9±4.2 minutes in 63 patients with first ERCP. Among the 9 SOD patients, 7 showed a decrease in basal pressure and (or) contraction frequency of the sphincter muscles after the administration ( χ2=5.143, P<0.05). No drug-related complication occurred during the operation in any of the patients. The incidences of post-ERCP pancreatitis and hyperamylasemia were 4.2% (3/72) and 8.3% (6/72), respectively. Conclusion:Local spray of dyclonine hydrochloride jelly can effectively suppress duodenal peristalsis, reduce basal pressure and contraction frequency of the sphincter, improve operational conditions, and increase the success rate of biliary cannulation with satisfactory safety in ERCP procedures for those who experience frequent intestinal peristalsis that may affect the procedure and are not suitable for the use of antispasmodics.
