Comparison of the therapeutic methods (pharmacologic and nonpharmacologic) on prevention of post-ERCP pancreatitis: A systematic review and meta-analysis
| Autor: | Morteza Ghojazadeh, Fatemeh Tahmasebi, Mohammad Hossein Somi, Amin Sadrazar, Elham Sheykhsaran, Hossein Hosseinfard, Masood Shirmohammadi |
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| Rok vydání: | 2021 |
| Předmět: |
Medicine (General)
medicine.medical_specialty Endoscopic retrograde cholangiopancreatography medicine.diagnostic_test business.industry Incidence (epidemiology) nsaids Cochrane Library Random effects model medicine.disease post-ercp R5-920 systematic review Meta-analysis Internal medicine Relative risk Medicine Pancreatitis prophylaxis Complication business hydration |
| Zdroj: | Journal of Research in Clinical Medicine, Vol 9, Iss 1, Pp 17-17 (2021) |
| ISSN: | 2717-0616 |
| DOI: | 10.34172/jrcm.2021.017 |
| Popis: | Background: Pancreatitis is considered as the most prevalent serious disorders of endoscopic retrograde cholangiopancreatography (ERCP). Different approaches have been suggested to prevent or reduce this complication. Therefore we aim to investigate them in the current study. This systematic review was performed in 2019 using Pubmed, Embase, google scholar and Cochrane library. Two reviewers selected eligible studies and outcomes of interest were extracted. Meta-analysis was done by using the random or fixed-effect models. I-square statistic test was used for heterogeneity analysis. Material and Methods: Totally, 2758 articles were searched. Thereafter duplicated and irrelevant articles were excluded, and six articles were entered to the present study. Six RCTs were considered eligible with a total participants of 1685. Results: The relative risk of PEP was not significantly different in NSAID and hydration groups (Pooled RR=1.19, 95%CI: 0.40 to 3.50, P-value=0.74). The random effect model indicated no significant differences between NSAID and NSAID+hydration groups regarding the incidence of PEP (Pooled RR=2.19, 95%CI: 0.70 to 6.88, P-value=0.17). Conclusion: Additionally, the results of one study showed that rectal indomethacin alone appeared to be more effective for preventing PEP than no prophylaxis, PSP alone, and the combination of indomethacin and PSP. Using NSAIDs alone or the combination of NSAIDs and hydration can reduce the risk of post-ERCP pancreatitis. Lack of studies comparing different approaches of prophylaxis in post-ERCP patient or the reporting of different parameters among the existing studies seriously limited the possibility and quality of meta-analysis. Further well-designed studies with accurate reporting of data is necessary to provide more reliable conclusion. |
| Databáze: | OpenAIRE |
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