A RANDOMIZED STUDY COMPARING GLUCAGON AND HYOSCINE N-BUTYL BROMIDE BEFORE ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY

Background: This study tried to resolve whether glucagon is a better p remedication for endoscopic retrograde cholangiopancreatography (ERCP) . Methods: We first measured the basal blood sugar and amylase levels. Then an endoscope was placed in the duodenum without premedication, a nd basal pulse and duodenal peristaltic rates were measured. ERCP bega n after studied subjects were randomly premedicated with either 1 mg g lucagon (n = 38) or 40 mg hyoscine N-butyl bromide (n = 36) intravenou sly. Ten minutes later the variables were measured again. Results: Glu cagon elicited hyperglycemia whereas hyoscine N-butyl bromide manifest ed an anticholinergic effect. No difference was found between these tw o groups with regard to the necessary interval for ERCP (20.6 +/- 14.1 min versus 21.4 +/- 14.7 min; NS) or the success rate for cholangiopa ncreatography (92.1% versus 91.7%; NS). Neither hyperamylasemia nor pa ncreatitis was preventable when glucagon was used. Conclusions: The tw o premedications appear equally effective in the performance of ERCP.