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Role of nonsteroidal anti-inflammatory drugs in the prevention of post-ERCP pancreatitis: a meta-analysis.
Hepatobiliary Pancreat Dis Int. 2009 Feb; 8(1):11-6.HP

Abstract

BACKGROUND

The role of prophylactic nonsteroidal anti-inflammatory drugs (NSAIDs) for reduction of pancreatitis after endoscopic retrograde cholangiopancreatography (ERCP) is debated. We performed a meta-analysis of all published randomized controlled trials to evaluate the efficacy of NSAIDs in the prevention of post-ERCP pancreatitis.

DATA SOURCES

Searches were conducted in the databases PubMed, EMBASE and the Cochrane Library. Six randomized clinical trials that fulfilled the inclusion criteria and addressed the clinical questions of this analysis were further assessed. Data were extracted by two independent observers according to predetermined criteria.

RESULTS

The risk of pancreatitis was lower in the NSAID group than in the placebo group (OR: 0.46, 95% CI: 0.32 to 0.65, P<0.0001). Two hours after ERCP, prophylactic administration of NSAIDs was associated with a lower serum amylase level (WMD: -91.09, 95% CI: -149.78 to -32.40, P=0.002), but there was no difference in mean 24-hour serum amylase values (WMD: -379.00, 95% CI: -805.75 to 47.76, P=0.08). No deaths or NSAID-related complications were noted.

CONCLUSIONS

Prophylactic administration of NSAIDs can reduce the incidence of post-ERCP pancreatitis; this administration in patients undergoing ERCP is recommended. Further randomized controlled trials are required before its introduction into routine care.

Authors+Show Affiliations

Zhejiang University School of Medicine, Hangzhou 310058, China.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Meta-Analysis

Language

eng

PubMed ID

19208508

Citation

Dai, Hui-Fen, et al. "Role of Nonsteroidal Anti-inflammatory Drugs in the Prevention of post-ERCP Pancreatitis: a Meta-analysis." Hepatobiliary & Pancreatic Diseases International : HBPD INT, vol. 8, no. 1, 2009, pp. 11-6.
Dai HF, Wang XW, Zhao K. Role of nonsteroidal anti-inflammatory drugs in the prevention of post-ERCP pancreatitis: a meta-analysis. HBPD INT. 2009;8(1):11-6.
Dai, H. F., Wang, X. W., & Zhao, K. (2009). Role of nonsteroidal anti-inflammatory drugs in the prevention of post-ERCP pancreatitis: a meta-analysis. Hepatobiliary & Pancreatic Diseases International : HBPD INT, 8(1), 11-6.
Dai HF, Wang XW, Zhao K. Role of Nonsteroidal Anti-inflammatory Drugs in the Prevention of post-ERCP Pancreatitis: a Meta-analysis. HBPD INT. 2009;8(1):11-6. PubMed PMID: 19208508.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Role of nonsteroidal anti-inflammatory drugs in the prevention of post-ERCP pancreatitis: a meta-analysis. AU - Dai,Hui-Fen, AU - Wang,Xiao-Wen, AU - Zhao,Kui, PY - 2009/2/12/entrez PY - 2009/2/12/pubmed PY - 2009/5/30/medline SP - 11 EP - 6 JF - Hepatobiliary & pancreatic diseases international : HBPD INT JO - HBPD INT VL - 8 IS - 1 N2 - BACKGROUND: The role of prophylactic nonsteroidal anti-inflammatory drugs (NSAIDs) for reduction of pancreatitis after endoscopic retrograde cholangiopancreatography (ERCP) is debated. We performed a meta-analysis of all published randomized controlled trials to evaluate the efficacy of NSAIDs in the prevention of post-ERCP pancreatitis. DATA SOURCES: Searches were conducted in the databases PubMed, EMBASE and the Cochrane Library. Six randomized clinical trials that fulfilled the inclusion criteria and addressed the clinical questions of this analysis were further assessed. Data were extracted by two independent observers according to predetermined criteria. RESULTS: The risk of pancreatitis was lower in the NSAID group than in the placebo group (OR: 0.46, 95% CI: 0.32 to 0.65, P<0.0001). Two hours after ERCP, prophylactic administration of NSAIDs was associated with a lower serum amylase level (WMD: -91.09, 95% CI: -149.78 to -32.40, P=0.002), but there was no difference in mean 24-hour serum amylase values (WMD: -379.00, 95% CI: -805.75 to 47.76, P=0.08). No deaths or NSAID-related complications were noted. CONCLUSIONS: Prophylactic administration of NSAIDs can reduce the incidence of post-ERCP pancreatitis; this administration in patients undergoing ERCP is recommended. Further randomized controlled trials are required before its introduction into routine care. SN - 1499-3872 UR - https://www.unboundmedicine.com/medline/citation/19208508/Role_of_nonsteroidal_anti_inflammatory_drugs_in_the_prevention_of_post_ERCP_pancreatitis:_a_meta_analysis_ L2 - http://www.diseaseinfosearch.org/result/9663 DB - PRIME DP - Unbound Medicine ER -