Clinical effect of ulinastatin in preventing pancreatitis after endoscopic retrograde cholangiopancreatography:a Meta -analysis
10.3969/j.issn.1001-5256.2017.01.024
- VernacularTitle:乌司他丁预防经内镜逆行胰胆管造影术后胰腺炎的 Meta 分析
- Author:
Lu LI
;
Hongcheng WEI
;
Shufen FENG
- Keywords:
pancreatitis;
cholangiopancreatography,endoscopic retrograde;
postoperative complications;
ulinastatin;
Meta -analysis
- From:
Journal of Clinical Hepatology
2017;33(1):110-115
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the clinical effect of ulinastatin in preventing pancreatitis after endoscopic retrograde cholangiopancre-atography (ERCP).Methods The Cochrane Library,PubMed,EMBASE,CNKI,VIP,and Wanfang Data were searched for randomized controlled trials (RCTs)on ulinastatin for the prevention of post -ERCP pancreatitis published from 1970 to June 2016.Two researchers se-lected RCTs,extracted data,and evaluated methodological quality independently,and RevMan 5.3 software was used for the meta -analy-sis.The chi -square test was used for the heterogeneity analysis of RCTs included,and the funnel plots were used to evaluate publication bi-as.Results A total of six RCTs with 923 patients were included in this analysis.Compared with the placebo,ulinastatin had significantly better effects in preventing post -ERCP pancreatitis (OR =0.26,95%CI:0.13 -0.53,P =0.000 2),hyperamylasemia (OR =0.47, 95%CI:0.33 -0.67,P <0.001),and abdominal pain (OR =0.56,95%CI:0.34 -0.91,P =0.020).Compared with gabexate,uli-nastatin had similar effects in preventing post -ERCP pancreatitis,hyperamylasemia,and abdominal pain (P =0.52,0.13,and 0.79);low -dose ulinastatin also had similar effects as gabexate in preventing post -ERCP pancreatitis and hyperamylasemia (P =0.49 and 0.25).The funnel plots based on the effect of ulinastatin in preventing post -ERCP pancreatitis were slightly asymmetric,which suggested the presence of publication bias.Conclusion Ulinastatin (≥15 ×104 U)can effectively prevent post -ERCP pancreatitis,hyperlipi-demia,and abdominal pain in the general population and it is recommended to start using this drug before surgery.
