Prospects of the use of M-cholinolytics in the complex treatment of patients with obstructive diseases of the hepatobiliary zone | Ukrainian Medical Journal

Aim: to establish and highlight the prospects of the use of M-cholinolytic antispasmodics in the complex treatment of obstructive diseases of the hepatopancreatobiliary zone based on the usage of M-cholinolytic antispasmodic drugs.

Materials and methods. In the period from 2021 to 2023, we conducted a study evaluating the effectiveness of drugs with M-cholinolytic effect in the surgical department No. 2 of the Kyiv City Clinical Hospital of Emergency Care. The study included 303 patients with various pathologies of the hepatopancreatobiliary zone, such as mechanical jaundice of benign origin, acute calculous cholecystitis, acute biliary pancreatitis, as well as patients in the early postoperative period after cholecystectomies (including laparoscopic and traditional laparotomy operations) and endoscopic transpapillary interventions.

The results. The inclusion of M-cholinolytics into complex treatment significantly improved the course of the disease in patients of the main group.

Conclusion. Based on the positive effect of M-cholinolytic therapy in patients with mechanical jaundice, it is clinically justified to include M-cholinolytic drugs in standard protocols of complex conservative therapy for mechanical jaundice.

References

1. Treinen C., Lomelin D., Krause C. et al. (2015) Acute acalculous cholecystitis in the critically ill: risk factors and surgical strategies. Langenbecks Arch. Surg., 400(4): 421–427. doi: 10.1007/s00423-014-1267-6.
2. Tsimmerman I.S. (2010) Abdominal pain syndrome: etiology, pathogenesis, diagnosis and treatment. Klin. Med. (Mosk.), 88(2): 14–21.
3. Lacy B.E., Cangemi D., Vazquez-Roque M. (2021) Management of Chronic Abdominal Distension and Bloating. Clin. Gastroenterol. Hepatol., 19(2): 219–231. doi: 10.1016/j.cgh.2020.03.056.
4. Tytgat G.N. (2007) Hyoscine butylbromide: a review of its use in the treatment of abdominal cramping and pain. Drugs, 67(9): 1343–1357. doi: 10.2165/00003495-200767090-00007.
5. Den Hertog A., Van den Akker J. (1987) Modification of alpha 1-receptor-operated channels by mebeverine in smooth muscle cells of guinea-pig taenia caeci. Eur. J. Pharmacol., 138(3): 367–374. doi: 10.1016/0014-2999(87)90475-4.
6. Allescher H.D. (2015) Sphinkter-Oddi-Dyskinesie. Internist (Berl.), 56(6): 638, 640–644, 646–647. doi: 10.1007/s00108-014-3605-8.
7. Slichko I.O., Lobanov S.M., Dyrda O.O. (2013) Optimisation of spasmolityc therapy of surgical patients. Ukr. J. Surg., 2: 66–67.
8. Weibel S., Rücker G., Eberhart L.H. et al. (2020) Drugs for preventing postoperative nausea and vomiting in adults after general anaesthesia: a network meta-analysis. Cochrane Database Syst. Rev., 10(10): CD012859. doi: 10.1002/14651858.CD012859.pub2.
9. Brenner D.M., Lacy B.E. (2021) Antispasmodics for Chronic Abdominal Pain: Analysis of North American Treatment Options. Am. J. Gastroenterol., 116(8): 1587–1600. doi: 10.14309/ajg.0000000000001266.
10. Toouli J. (1991) Biliary tract motor dysfunction. Baillieres Clin. Gastroenterol., 5(2): 409–430. doi: 10.1016/0950-3528(91)90035-y.
11. Zozulia I.S., Maksymenko M.V., Zozulia A.I. (2016) Pain: approaches to diagnostics and treatment in neurology and surgery. Ukr. Med. J., 2(112): umj.com.ua/en/publication-147383.
12. Shih H.Y., Hsu W.H., Kuo C.H. (2019) Postendoscopic retrograde cholangiopancreatography pancreatitis. Kaohsiung. J. Med. Sci., 35(4): 195–201. doi: 10.1002/kjm2.12040.