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Nonsteroidal anti‐inflammatory drugs reduce the incidence of post‐endoscopic retrograde cholangiopancreatography pancreatitis: a meta‐analysis
Author(s) -
Li Lin,
Han Zhen,
Yuan Heming,
Zhang Guozheng,
Jia Yuliang,
He Chiyi
Publication year - 2017
Publication title -
journal of hepato‐biliary‐pancreatic sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.63
H-Index - 60
eISSN - 1868-6982
pISSN - 1868-6974
DOI - 10.1002/jhbp.489
Subject(s) - medicine , pancreatitis , endoscopic retrograde cholangiopancreatography , randomized controlled trial , gastroenterology , placebo , incidence (geometry) , relative risk , acute pancreatitis , nonsteroidal , confidence interval , pathology , physics , alternative medicine , optics
Abstract Background Several recent studies suggested that nonsteroidal anti‐inflammation drugs ( NSAID s) could prevent the pancreatitis after endoscopic retrograde cholangiopancreatography ( ERCP ). However, the routes of administration, the dosages of NSAID s and the potential efficacy in reducing the severity of pancreatitis remain controversial. The aim of this meta‐analysis was to evaluate the efficacy of NSAID s for post‐ ERCP pancreatitis ( PEP ) prophylaxis. Methods We systematically searched PubMed, Embase, EBSCO , Elsevier and Web of Science databases up to 1 October 2016 for relevant studies. Results A total of 24 studies met the inclusion criteria. Compared to the controls, the risk of pancreatitis was much lower in the NSAID s group ( OR = 0.57, 95% CI : 0.48–0.67, P < 0.0001). However, NSAID s were not effective in reducing the risk of moderate to severe pancreatitis compared with placebo ( OR = 0.75, 95% CI : 0.57–1.00). In the subanalyses, rectal administration was the only effective route ( OR = 0.51, 95% CI : 0.42–0.62), and the risk of PEP was reduced in both randomized controlled trials ( RCT s) ( OR = 0.63, 95% CI : 0.52–0.76) and case–control articles (C–Cs) ( OR = 0.40, 95% CI : 0.28–0.58). Conclusions Prophylactic administration of NSAID s reduced the incidence of PEP in both RCT s and C–Cs, especially when rectally administered, but was not effective in reducing the risk of moderate to severe pancreatitis.