UNASSIGNED: 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.
UNASSIGNED: 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.
UNASSIGNED: 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.
■我们纳入了预防急性ERCP后胰腺炎的药物干预的临床试验。评估的事件为急性胰腺炎。我们在MEDLINE(OVID)中进行了搜索策略,EMBASE,和Cochrane中央控制试验登记册,从成立到现在。我们报告了相对风险(RR)的信息,置信区间为95%。我们使用I2检验评估异质性。
■我们纳入了84项研究进行分析(30,463例患者)。平均年龄为59.3岁(SD±7.01)。研究之间的异质性较低(I2=34.4%),没有不一致(p=0.2567)。使用NSAIDs预防的ERCP术后胰腺炎较少(RR0.6595%CI[0.52,0.80]),乳酸林格积极水合作用(RR0.3295%CI[0.12-0.86]),与安慰剂相比,NSAIDs+硝酸异山梨酯(RR0.2895%CI[0.11-0.71])和生长抑素及其类似物(RR0.54[0.43至0.68])。
■NSAIDs,NSAIDs+硝酸异山梨酯的组合,生长抑素和类似物,与安慰剂相比,与乳酸林格液的积极水合作用是可以预防ERCP后胰腺炎的药理学策略.需要更多的临床试验来确定这些药物的有效性。