The effect of glucocorticosteroids in prevention of post-ERCP pancreatitis:a meta-analysis
- VernacularTitle:糖皮质激素预防ERCP术后胰腺炎的Meta分析
- Author:
Wenming YUAN
;
Jing LI
;
Lin XU
;
- Publication Type:Journal Article
- Keywords:
glucocorticoids;
cholangiopancreatography,endoscopic retrograde;
pancreatitis;
Meta-analysis
- From:
Medical Journal of Chinese People's Liberation Army
2001;0(08):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the effect and safety of glucocorticosteroids in prevention of post-ERCP pancreatifis(post-endo- scopic retrograde cholangiopancreatography pancreatitis,PEP).Methods The database of Cochrane Library(issue 4,2006),Medline (1966-2007.1),EMBASE(1986-2007.1)and CBM(1978-2007.1)were searched.The cited literature of obtained articles and some core English and Chinese medical journals(July,2006-Jan,2007)relevant to gastro-enterolngy were also searched by hand.All random- ized controlled trials(RCT)comparing glucocorticosteroids to placeboes in prevention of PEP were included.Data collection and literature evaluation were performed by two reviewers independently.RevMan 4.2.8 was used for statistical analysis.Result Six RCTs were includ- ed in meta-analysis which showed no statistical difference for the incidence of overall PEP between the glucocorticosteroids group and place- bo group(RR=1.11,95%CI 0.89-1.39).Stratified by severity of PEP,four trials were included.Meta-analysis showed no statistical difference for the incidence of mild to moderate PEP and severe PEP between the two groups(RR=1.17,95%CI 0.91-1.51 for mild- moderate PEP;RR=1.79,95%CI 0.69-4.65 for severe PEP).Stratified by therapeutic ERCP,three RCTs were included.Meta-analy- sis showed no statistical difference for the incidence of PEP between the two groups(RR=1.24,95%CI 0.91-1.67).3 trials as to inter- im-analysis were excluded by sensitive analysis.Meta-analysis also showed no statistical difference for the incidence of PEP between the two groups(RR=0.73,95%CI 0.44-1.20).Conclusion Based on current evidence,glucocorticosteroids is not beneficial in preventing the occurrence of PEP.Further high quality study is needed to disclose the efficacy of glucocorticosteroids in prevention of PEP.
