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Gabexate in the prophylaxis of post-ERCP pancreatitis: a meta-analysis of randomized controlled trials.
BMC Gastroenterol 2007; 7:6BG

Abstract

BACKGROUND

Acute pancreatitis is a common complication of endoscopic retrograde cholangiopancreatography and the benefit of its pharmacological treatment is unclear. Although prophylactic use of gabexate for the reduction of pancreatic injury after ERCP has been evaluated, the discrepancy about gabexate's beneficial effect on pancreatic injury still exists. This study aimed to evaluate the effectiveness and safety of gabexate in the prophylaxis of post-endoscopic retrograde cholangiopancreatography pancreatitis (PEP).

METHODS

We employed the method recommended by the Cochrane Collaboration to perform a meta-analysis of randomized controlled trials (RCTs) of gabexate in the prevention of post-ERCP pancreatitis (PEP) including three RCTs conducted in Italy and one in China.

RESULTS

All of the four RCTs were of high quality. When the RCTs were analyzed, odds ratios (OR) for gabexate mesilate were 0.67 [95% CI (0.31 to approximately 1.47), p = 0.32] for PEP, 3.78 [95% CI (0.62 to approximately 22.98), p = 0.15] for severe PEP, 0.68 [95% CI (0.19 to approximately 2.43), p = 0.56] for the case-fatality of PEP, 0.88 [95% CI (0.72 to approximately 1.07), p = 0.20] for post-ERCP hyperamylasemia, 0.69 [95% CI (0.39 to approximately 1.21), p = 0.19] for post-ERCP abdominal pain, thus indicating no beneficial effects of gabexate on acute pancreatitis, the death rate of PEP, hyperamylasemia and abdominal pain. No evidence of publication bias was found.

CONCLUSION

Gabexate mesilate can not prevent the pancreatic injury after ERCP. It is not recommended for the use of gabexate mesilate in the prophylaxis of PEP.

Authors+Show Affiliations

Department of Infection and Liver Disease, The First Affiliated Hospital of Wenzhou Medical College, Wenzhou, China. blueman1320@163.com <blueman1320@163.com>No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Meta-Analysis

Language

eng

PubMed ID

17295917

Citation

Zheng, Minghua, et al. "Gabexate in the Prophylaxis of post-ERCP Pancreatitis: a Meta-analysis of Randomized Controlled Trials." BMC Gastroenterology, vol. 7, 2007, p. 6.
Zheng M, Chen Y, Yang X, et al. Gabexate in the prophylaxis of post-ERCP pancreatitis: a meta-analysis of randomized controlled trials. BMC Gastroenterol. 2007;7:6.
Zheng, M., Chen, Y., Yang, X., Li, J., Zhang, Y., & Zeng, Q. (2007). Gabexate in the prophylaxis of post-ERCP pancreatitis: a meta-analysis of randomized controlled trials. BMC Gastroenterology, 7, p. 6.
Zheng M, et al. Gabexate in the Prophylaxis of post-ERCP Pancreatitis: a Meta-analysis of Randomized Controlled Trials. BMC Gastroenterol. 2007 Feb 12;7:6. PubMed PMID: 17295917.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Gabexate in the prophylaxis of post-ERCP pancreatitis: a meta-analysis of randomized controlled trials. AU - Zheng,Minghua, AU - Chen,Yongping, AU - Yang,Xinjun, AU - Li,Ji, AU - Zhang,Youcai, AU - Zeng,Qiqiang, Y1 - 2007/02/12/ PY - 2006/10/10/received PY - 2007/02/12/accepted PY - 2007/2/14/pubmed PY - 2007/3/21/medline PY - 2007/2/14/entrez SP - 6 EP - 6 JF - BMC gastroenterology JO - BMC Gastroenterol VL - 7 N2 - BACKGROUND: Acute pancreatitis is a common complication of endoscopic retrograde cholangiopancreatography and the benefit of its pharmacological treatment is unclear. Although prophylactic use of gabexate for the reduction of pancreatic injury after ERCP has been evaluated, the discrepancy about gabexate's beneficial effect on pancreatic injury still exists. This study aimed to evaluate the effectiveness and safety of gabexate in the prophylaxis of post-endoscopic retrograde cholangiopancreatography pancreatitis (PEP). METHODS: We employed the method recommended by the Cochrane Collaboration to perform a meta-analysis of randomized controlled trials (RCTs) of gabexate in the prevention of post-ERCP pancreatitis (PEP) including three RCTs conducted in Italy and one in China. RESULTS: All of the four RCTs were of high quality. When the RCTs were analyzed, odds ratios (OR) for gabexate mesilate were 0.67 [95% CI (0.31 to approximately 1.47), p = 0.32] for PEP, 3.78 [95% CI (0.62 to approximately 22.98), p = 0.15] for severe PEP, 0.68 [95% CI (0.19 to approximately 2.43), p = 0.56] for the case-fatality of PEP, 0.88 [95% CI (0.72 to approximately 1.07), p = 0.20] for post-ERCP hyperamylasemia, 0.69 [95% CI (0.39 to approximately 1.21), p = 0.19] for post-ERCP abdominal pain, thus indicating no beneficial effects of gabexate on acute pancreatitis, the death rate of PEP, hyperamylasemia and abdominal pain. No evidence of publication bias was found. CONCLUSION: Gabexate mesilate can not prevent the pancreatic injury after ERCP. It is not recommended for the use of gabexate mesilate in the prophylaxis of PEP. SN - 1471-230X UR - https://www.unboundmedicine.com/medline/citation/17295917/Gabexate_in_the_prophylaxis_of_post_ERCP_pancreatitis:_a_meta_analysis_of_randomized_controlled_trials_ L2 - https://bmcgastroenterol.biomedcentral.com/articles/10.1186/1471-230X-7-6 DB - PRIME DP - Unbound Medicine ER -