%0 Journal Article
%T Effectiveness of the pharmacological therapy to prevent post ERCP acute pancreatitis: a network meta-analysis.
%A Rojas-Victoria EJ
%A Hernández-Ruiz SI
%A García-Perdomo HA
%J Expert Rev Gastroenterol Hepatol
%V 18
%N 4
%D 2024 Apr-May 9
%M 38725175
%F 4.095
%R 10.1080/17474124.2024.2345640
%X UNASSIGNED: To determine the effectiveness of the different pharmacological agents in preventing post-ERCP acute pancreatitis.
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.