Effectiveness of the pharmacological therapy to prevent post ERCP acute pancreatitis: a network meta-analysis.
Expert Rev Gastroenterol Hepatol
; 18(4-5): 203-215, 2024.
Article
en En
| MEDLINE
| ID: mdl-38725175
ABSTRACT
OBJECTIVE:
To determine the effectiveness of the different pharmacological agents in preventing post-ERCP acute pancreatitis.METHODS:
We included clinical trials of pharmacological interventions for prophylaxis of acute post-ERCP pancreatitis. The event evaluated was acute pancreatitis. We conducted a search strategy in MEDLINE (OVID), EMBASE, and Cochrane Central Register of Controlled Trials from inception to nowadays. We reported the information in terms of relative risks (RR) with a 95% confidence interval. We assessed the heterogeneity using the I2 test.RESULTS:
We included 84 studies for analysis (30,463 patients). The mean age was 59.3 years (SD ± 7.01). Heterogeneity between studies was low (I2 = 34.4%) with no inconsistencies (p = 0.2567). Post ERCP pancreatitis was less in prophylaxis with NSAIDs (RR 0.65 95% CI [0.52 to 0.80]), aggressive hydration with Lactate Ringer (RR 0.32 95% CI [0.12-0.86]), NSAIDs + isosorbide dinitrate (RR 0.28 95% CI [0.11-0.71]) and somatostatin and analogues (RR 0.54 [0.43 to 0.68]) compared with placebo.CONCLUSIONS:
NSAIDs, the Combination of NSAIDs + isosorbide dinitrate, somatostatin and analogues, and aggressive hydration with lactate ringer are pharmacological strategies that can prevent post-ERCP pancreatitis when compared to placebo. More clinical trials are required to determine the effectiveness of these drugs.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Pancreatitis
/
Antiinflamatorios no Esteroideos
/
Colangiopancreatografia Retrógrada Endoscópica
Límite:
Aged
/
Humans
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Middle aged
Idioma:
En
Revista:
Expert Rev Gastroenterol Hepatol
Asunto de la revista:
GASTROENTEROLOGIA
Año:
2024
Tipo del documento:
Article
País de afiliación:
Colombia
Pais de publicación:
Reino Unido