simethicone and Pancreatic-Diseases

Endoscopic retrograde cholangiopancreaticography (ERCP) is performed for diagnostic and therapeutic purposes in patients with pancreaticobiliary diseases. We investigated the role of simethicone and concomitant otilonium bromide during ERCP.. This prospective randomized study included 120 patients who underwent ERCP (study and control group=60 patients each). The study group received otilonium bromide and simethicone. The control group received no medication.. The quantity of duodenal foam and bubbles in the study group was significantly lesser than that in the control group. The duodenal motility score was 2.1±0.7 and 4.3±0.9 in the study and the control groups, respectively. Endoscopist satisfaction was good in 82%, moderate in 15%, and poor in 3% of ERCPs in the study group and good in 15%, moderate in 65%, and poor in 25% of ERCPs in the control group. The study group showed a shorter ERCP duration than the control group.. Simethicone and otilonium bromide administered concomitantly reduce duodenal motility and foam/bubble formation, which facilitates papilla of Vater catheterization to reduce procedure time.

Topics: Adult; Aged; Antifoaming Agents; Biliary Tract Diseases; Cholangiopancreatography, Endoscopic Retrograde; Duodenum; Female; Follow-Up Studies; Gastrointestinal Motility; Humans; Male; Middle Aged; Operative Time; Pancreatic Diseases; Preoperative Care; Prospective Studies; Quality Improvement; Quaternary Ammonium Compounds; Simethicone; Treatment Outcome

Topics: Abdomen; Adult; Aged; Aged, 80 and over; Cellulose; Contrast Media; Double-Blind Method; Drug Combinations; Female; Humans; Male; Middle Aged; Pancreas; Pancreatic Diseases; Simethicone; Splenic Vein; Ultrasonography

Using 750 outpatients as our material, the effects of dimethicon , simethicon - pankreatin and lysin-vasopressin, of the position of the patient and of the filling of the stomach with soup on the success of pancreatic ultrasonography were studied. Dimethicon had no, simethicon - pankreatin an almost significant and lysin-vasopressin a highly significant positive effect. Lysin-vasopressin caused several mild adverse reactions. The filling of the stomach with soup combined with erect position was effective in about 3/4 of the cases. Prone position was not usefull.

Topics: Clinical Trials as Topic; Contrast Media; Double-Blind Method; Gases; Humans; Intestines; Lypressin; Methods; Pancreatic Diseases; Pancreatin; Posture; Simethicone; Stomach; Ultrasonography

The authors performed this study to compare the cost and diagnostic abilities of ultrasound (US) performed with and without the use of an oral contrast material recently approved by the U.S. Food and Drug Administration.. An interactive decision-analytic model was constructed to compare US performed with and without contrast material (SonoRx; Bracco Diagnostics) for the evaluation of patients with abdominal pain who were suspected of having pancreatic disease. The model considered all resources that might be used to evaluate a patient suspected of having pancreatic disease (eg, US, computed tomography [CT], endoscopic retrograde cholangiopancreatography, fine-needle aspiration biopsy, and open biopsy). The literature and an expert panel were the clinical data sources. Cost estimates were based on Medicare and non-Medicare reimbursements. The primary cost-effectiveness measure was the cost to achieve a diagnosis.. SonoRx-enhanced US was less expensive than unenhanced US ($714 vs $808, respectively, with Medicare costs; $1,612 vs $1,878, respectively, with non-Medicare costs) and as effective (0.785 vs 0.782, respectively). SonoRx-enhanced US was more cost-effective than unenhanced US ($909 vs $1,034, respectively, with Medicare costs; $2,052 vs $2,401, respectively, with non-Medicare costs). This relationship was maintained throughout extensive sensitivity analyses.. SonoRx-enhanced US is more cost-effective than unenhanced US, primarily because it avoids the need for CT. CT may be avoided owing to the higher probability of obtaining optimal US scans with oral contrast material.

Topics: Abdominal Pain; Administration, Oral; Cellulose; Contrast Media; Cost-Benefit Analysis; Decision Making; Diagnosis, Differential; Humans; Insurance, Health, Reimbursement; Models, Economic; Pancreatic Diseases; Sensitivity and Specificity; Simethicone; Ultrasonography

The characteristics of the echo structure constitute an important criterion for the appraisal of sonograms. Since every pixel usually represents one out of 64 gray values, it should be possible to use the density as an objective parameter of the echo structure. In this study, the echogenicity of the pancreas was examined. The density of the pancreas became higher with increasing accumulation of fatty connective tissue or as a result of air in the intestine. In 42 people with varying degrees of obesity, the echo structure was compared with the gray scale distribution of the lumen of the gallbladder, aorta and the water-filled stomach. The results indicated that the increasing echodensity is attributable to reflections and scatter of the ultrasound in adjacent regions. The presence of air gave rise to the same effect. On the basis of standardized investigations at 15-minute intervals, the density and the visual index under the influence of a quick-acting simethicone preparation (Lefax) were compared. The density also decreased significantly within 30 to 45 minutes parallel to the reduction of superimpositional interferences due to air. The present investigations confirm the relevance of gray scale analysis for objective confirmation of sonographic structures. However, they make it evident that the echo pattern is quantifiable only under standardized conditions and when the projection plane is largely occupied. Misleading mixed values are measured in marginal zones and in superimpositions.

Topics: Aorta; Diagnosis, Differential; Gallbladder; Humans; Liver; Liver Diseases; Pancreas; Pancreatic Diseases; Reference Values; Simethicone; Stomach; Ultrasonography