Efficacy of Hymecromone in Post-Cholecystectomy Patients
Background. The cholecystectomy is the major cause of sphincter of Oddi dysfunction (SOD), that may be classified as post-cholecystectomy syndrome (PCES). Treatment of PCES requires in most of the cases application of selective antispasmodic drugs.Aim. To evaluate efficacy and safety of hymecromone...
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Gastro LLC
2021-12-01
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| Series: | Российский журнал гастроэнтерологии, гепатологии, колопроктологии |
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| Online Access: | https://www.gastro-j.ru/jour/article/view/636 |
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| author | A V. Okhlobystin A. К. Ufimtseva M. A. Tatarkina O. Z. Okhlobystina V. T. Ivashkin |
| author_facet | A V. Okhlobystin A. К. Ufimtseva M. A. Tatarkina O. Z. Okhlobystina V. T. Ivashkin |
| author_sort | A V. Okhlobystin |
| collection | DOAJ |
| description | Background. The cholecystectomy is the major cause of sphincter of Oddi dysfunction (SOD), that may be classified as post-cholecystectomy syndrome (PCES). Treatment of PCES requires in most of the cases application of selective antispasmodic drugs.Aim. To evaluate efficacy and safety of hymecromone in patients with post-cholecystectomy SOD, to compare standard and reduced doses of hymecromone.Methods. Overall, 26 patients were enrolled in non-interventional comparative study: 2 males, 24 females, aged from 25 to 74 years. All patients underwent cholecystectomy for symptomatic gallstone disease within 1 to 10 years prior to beginning of the study. All patients were diagnosed to have SOD according to Rome IV Diagnostic Criteria for functional biliary sphincter of Oddi disorder (E1b). All patients underwent hymecromone monotherapy for 3 weeks. Patients were randomized to group A and B to receive full-dose or half-dose of the drug respectively.Results. Abdominal pain completely subsided in 85 % of patients, significant improvement was found for bloating and diarrhea. Mild increase in fasting common bile duct (CBD) diameter after treatment (7.23 ± 0.99 vs 6.78 ± 1.01; p = 0.029) was attributed to choleretic action of hymecromone. Hymecromone resulted in significant improvement of CBD response to fatty meal stimulation (ΔCBD): –1.08 ± 0.46 mm vs –0.10 ± 0.33 mm pretreatment (p = 0.016). Degree of improvement was more pronounced in the group A (full-dose) as compared to group B (half-dose) for abdominal pain (Z = 2.74, p = 0.031), bloating (Z = 2.63, p = 0.035) and constipation (Z = 2.61, p = 0.038)Conclusion. Hymecromone demonstrated itself to be an effective and safe drug, that may be applied both in standard and half dose. However, the efficacy of full-dose is higher both for the treatment of biliary pain and dyspeptic symptoms. Transabdominal ultrasound may be applied as a reliable test for both prediction of treatment efficacy and to monitor patients state during treatment course. |
| format | Article |
| id | doaj-art-0c39b2ebb7db4099808746490238bd8b |
| institution | Kabale University |
| issn | 1382-4376 2658-6673 |
| language | Russian |
| publishDate | 2021-12-01 |
| publisher | Gastro LLC |
| record_format | Article |
| series | Российский журнал гастроэнтерологии, гепатологии, колопроктологии |
| spelling | doaj-art-0c39b2ebb7db4099808746490238bd8b2025-02-10T16:14:37ZrusGastro LLCРоссийский журнал гастроэнтерологии, гепатологии, колопроктологии1382-43762658-66732021-12-01314374410.22416/1382-4376-2021-31-4-37-44436Efficacy of Hymecromone in Post-Cholecystectomy PatientsA V. Okhlobystin0A. К. Ufimtseva1M. A. Tatarkina2O. Z. Okhlobystina3V. T. Ivashkin4Sechenov First Moscow State Medical UniversitySechenov First Moscow State Medical UniversitySechenov First Moscow State Medical UniversitySechenov First Moscow State Medical UniversitySechenov First Moscow State Medical UniversityBackground. The cholecystectomy is the major cause of sphincter of Oddi dysfunction (SOD), that may be classified as post-cholecystectomy syndrome (PCES). Treatment of PCES requires in most of the cases application of selective antispasmodic drugs.Aim. To evaluate efficacy and safety of hymecromone in patients with post-cholecystectomy SOD, to compare standard and reduced doses of hymecromone.Methods. Overall, 26 patients were enrolled in non-interventional comparative study: 2 males, 24 females, aged from 25 to 74 years. All patients underwent cholecystectomy for symptomatic gallstone disease within 1 to 10 years prior to beginning of the study. All patients were diagnosed to have SOD according to Rome IV Diagnostic Criteria for functional biliary sphincter of Oddi disorder (E1b). All patients underwent hymecromone monotherapy for 3 weeks. Patients were randomized to group A and B to receive full-dose or half-dose of the drug respectively.Results. Abdominal pain completely subsided in 85 % of patients, significant improvement was found for bloating and diarrhea. Mild increase in fasting common bile duct (CBD) diameter after treatment (7.23 ± 0.99 vs 6.78 ± 1.01; p = 0.029) was attributed to choleretic action of hymecromone. Hymecromone resulted in significant improvement of CBD response to fatty meal stimulation (ΔCBD): –1.08 ± 0.46 mm vs –0.10 ± 0.33 mm pretreatment (p = 0.016). Degree of improvement was more pronounced in the group A (full-dose) as compared to group B (half-dose) for abdominal pain (Z = 2.74, p = 0.031), bloating (Z = 2.63, p = 0.035) and constipation (Z = 2.61, p = 0.038)Conclusion. Hymecromone demonstrated itself to be an effective and safe drug, that may be applied both in standard and half dose. However, the efficacy of full-dose is higher both for the treatment of biliary pain and dyspeptic symptoms. Transabdominal ultrasound may be applied as a reliable test for both prediction of treatment efficacy and to monitor patients state during treatment course.https://www.gastro-j.ru/jour/article/view/636gallstone diseasecholelithiasissphincter of oddi dysfunctionpost-cholecystectomy syndromefatty meal sonographypain |
| spellingShingle | A V. Okhlobystin A. К. Ufimtseva M. A. Tatarkina O. Z. Okhlobystina V. T. Ivashkin Efficacy of Hymecromone in Post-Cholecystectomy Patients Российский журнал гастроэнтерологии, гепатологии, колопроктологии gallstone disease cholelithiasis sphincter of oddi dysfunction post-cholecystectomy syndrome fatty meal sonography pain |
| title | Efficacy of Hymecromone in Post-Cholecystectomy Patients |
| title_full | Efficacy of Hymecromone in Post-Cholecystectomy Patients |
| title_fullStr | Efficacy of Hymecromone in Post-Cholecystectomy Patients |
| title_full_unstemmed | Efficacy of Hymecromone in Post-Cholecystectomy Patients |
| title_short | Efficacy of Hymecromone in Post-Cholecystectomy Patients |
| title_sort | efficacy of hymecromone in post cholecystectomy patients |
| topic | gallstone disease cholelithiasis sphincter of oddi dysfunction post-cholecystectomy syndrome fatty meal sonography pain |
| url | https://www.gastro-j.ru/jour/article/view/636 |
| work_keys_str_mv | AT avokhlobystin efficacyofhymecromoneinpostcholecystectomypatients AT akufimtseva efficacyofhymecromoneinpostcholecystectomypatients AT matatarkina efficacyofhymecromoneinpostcholecystectomypatients AT ozokhlobystina efficacyofhymecromoneinpostcholecystectomypatients AT vtivashkin efficacyofhymecromoneinpostcholecystectomypatients |