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Role of ulinastatin in preventing post-endoscopic retrograde cholangiopancreatography pancreatitis: the Emperor's New Clothes or Aladdin's Magic Lamp?
Pancreas. 2010 Nov; 39(8):1231-7.P

Abstract

OBJECTIVES

The role of prophylactic ulinastatin in the prevention of post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis is debated. A meta-analysis of all published randomized clinical trials was performed to evaluate the efficacy of ulinastatin on post-ERCP pancreatitis.

METHODS

Searches were conducted in multiple databases composed of PubMed, EMBASE, the Cochrane Library, the Science Citation Index Expanded, and the China National Knowledge Infrastructure series full-text database. Primary outcome was post-ERCP pancreatitis, with or without hyperamylasemia.

RESULTS

Seven randomized clinical trials fulfilling the inclusion criteria were selected for meta-analysis, 5 comparing ulinastatin with placebo and 2 for ulinastatin versus gabexate. The incidence of post-ERCP pancreatitis was reduced by ulinastatin (odds ratio, 0.53; 95% confidence interval, 0.31-0.89; P = 0.02; test for heterogeneity: I = 0%; P = 0.51), so was the event of hyperamylasemia (odds ratio, 0.42; 95% confidence interval, 0.30-0.59; P < 0.00001; test for heterogeneity: I = 13%; P = 0.33). Subsequent sensitivity and subgroup analyses produced conflicting results.

CONCLUSIONS

Ulinastatin shows to be of value on preventing post-ERCP pancreatitis and hyperamylasemia for patients in average risk, when given intravenously at a dose of not less than 150,000 U, just before ERCP. More high-quality trials are needed for further confirmation.

Authors+Show Affiliations

Department of Gastroenterology, First Affiliated Medical College of Wuhan University, Renmin Hospital of Wuhan University, Whuhan, China.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Meta-Analysis

Language

eng

PubMed ID

20531245

Citation

Chen, SuYu, et al. "Role of Ulinastatin in Preventing Post-endoscopic Retrograde Cholangiopancreatography Pancreatitis: the Emperor's New Clothes or Aladdin's Magic Lamp?" Pancreas, vol. 39, no. 8, 2010, pp. 1231-7.
Chen S, Shi H, Zou X, et al. Role of ulinastatin in preventing post-endoscopic retrograde cholangiopancreatography pancreatitis: the Emperor's New Clothes or Aladdin's Magic Lamp? Pancreas. 2010;39(8):1231-7.
Chen, S., Shi, H., Zou, X., & Luo, H. (2010). Role of ulinastatin in preventing post-endoscopic retrograde cholangiopancreatography pancreatitis: the Emperor's New Clothes or Aladdin's Magic Lamp? Pancreas, 39(8), 1231-7. https://doi.org/10.1097/MPA.0b013e3181dc67e7
Chen S, et al. Role of Ulinastatin in Preventing Post-endoscopic Retrograde Cholangiopancreatography Pancreatitis: the Emperor's New Clothes or Aladdin's Magic Lamp. Pancreas. 2010;39(8):1231-7. PubMed PMID: 20531245.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Role of ulinastatin in preventing post-endoscopic retrograde cholangiopancreatography pancreatitis: the Emperor's New Clothes or Aladdin's Magic Lamp? AU - Chen,SuYu, AU - Shi,Hong, AU - Zou,Xiaoping, AU - Luo,Hesheng, PY - 2010/6/10/entrez PY - 2010/6/10/pubmed PY - 2011/3/3/medline SP - 1231 EP - 7 JF - Pancreas JO - Pancreas VL - 39 IS - 8 N2 - OBJECTIVES: The role of prophylactic ulinastatin in the prevention of post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis is debated. A meta-analysis of all published randomized clinical trials was performed to evaluate the efficacy of ulinastatin on post-ERCP pancreatitis. METHODS: Searches were conducted in multiple databases composed of PubMed, EMBASE, the Cochrane Library, the Science Citation Index Expanded, and the China National Knowledge Infrastructure series full-text database. Primary outcome was post-ERCP pancreatitis, with or without hyperamylasemia. RESULTS: Seven randomized clinical trials fulfilling the inclusion criteria were selected for meta-analysis, 5 comparing ulinastatin with placebo and 2 for ulinastatin versus gabexate. The incidence of post-ERCP pancreatitis was reduced by ulinastatin (odds ratio, 0.53; 95% confidence interval, 0.31-0.89; P = 0.02; test for heterogeneity: I = 0%; P = 0.51), so was the event of hyperamylasemia (odds ratio, 0.42; 95% confidence interval, 0.30-0.59; P < 0.00001; test for heterogeneity: I = 13%; P = 0.33). Subsequent sensitivity and subgroup analyses produced conflicting results. CONCLUSIONS: Ulinastatin shows to be of value on preventing post-ERCP pancreatitis and hyperamylasemia for patients in average risk, when given intravenously at a dose of not less than 150,000 U, just before ERCP. More high-quality trials are needed for further confirmation. SN - 1536-4828 UR - https://www.unboundmedicine.com/medline/citation/20531245/Role_of_ulinastatin_in_preventing_post_endoscopic_retrograde_cholangiopancreatography_pancreatitis:_the_Emperor's_New_Clothes_or_Aladdin's_Magic_Lamp L2 - https://doi.org/10.1097/MPA.0b013e3181dc67e7 DB - PRIME DP - Unbound Medicine ER -