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Clinical Instructor, College of Pharmacy, University of Michigan, Ann Arbor, MI; Specialty Resident in Pediatric Pharmacotherapy, University of Michigan Hospitals and Health Centers
Clinical Assistant Professor, College of Pharmacy, University of Michigan; Clinical Pharmacist, University of Michigan Hospitals and Health Centers
Reprints: Imad F Btaiche PharmD BCNSP, Department of Pharmacy Services, University of Michigan Hospitals and Health Centers, UH2D301 Box 0008, 1500 E. Medical Center Dr., Ann Arbor, MI 48109-0008, fax 734/936-7027, imadb{at}umich.edu
OBJECTIVE: To review the role of sincalide in treating and preventing parenteral nutrition (PN)associated gallbladder disease.
DATA SOURCES: A MEDLINE (1996March 2004) search was performed using the key terms cholecystokinin, sincalide, parenteral nutrition, cholelithiasis, cholestasis, and sludge.
DATA SYNTHESIS: Five human studies investigated the safety and efficacy of sincalide in patients with PN-associated gallbladder disease. Sincalide at intravenous doses of 0.04 µg/kg 3 times daily increased bile flow and improved serum bilirubin levels. However, patients with advanced liver disease did not respond to sincalide therapy. Long-term follow-up data on sincalide effects on liver disease progression are not yet available.
CONCLUSIONS: Sincalide improved the signs of cholestasis. However, its long-term effects in preventing and treating PN-associated gallbladder disease remain unknown and its routine use for this indication cannot be recommended at this time.
Key Words: gall bladder disease, parenteral nutrition, sincalide
Published Online, August 17, 2004. www.theannals.com, DOI 10.1345/aph.1E153