Tags

Type your tag names separated by a space and hit enter

Prophylactic pancreatic stent placement and post-ERCP pancreatitis: an updated meta-analysis.
J Gastroenterol 2014; 49(2):343-55JG

Abstract

BACKGROUND AND AIM

Pancreatitis is one of the most frequent post-endoscopic retrograde cholangiopancreatography (ERCP) complications. Previous meta-analyses show that prophylactic pancreatic stent (PS) placement after ERCP is beneficial for the prevention of post-ERCP pancreatitis (PEP). However, the results of these meta-analyses are controversial due to the limited sample size of the eligible studies, in which six additional randomized controlled trials (RCTs) are not included. Our aim is, therefore, to update the current meta-analyses regarding PS placement for prevention of PEP.

METHODS

We conducted a meta-analysis to identify RCTs comparing PS placement and the subsequent incidence of PEP. The primary outcome was the incidence of PEP.

RESULTS

Fourteen studies were enrolled in this meta-analysis. Of the 1,541 patients, 760 patients received a PS and 781 patients were allocated to the control group. PS placement was associated with a statistically significant reduction of PEP [relative risk (RR) 0.39; 95 % confidence interval (CI) 0.29-0.53; P < 0.001]. Subgroup analysis stratified according to the severity of PEP showed that a PS was beneficial in patients with mild to moderate PEP (RR 0.45; 95 % CI 0.32-0.62; P < 0.001) and in patients with severe PEP (RR 0.26; 95 %CI 0.09-0.76; P = 0.01). In addition, subgroup analysis performed according to patient selection demonstrated that PS placement was effective for both high-risk and mixed case groups.

CONCLUSIONS

This meta-analysis showed that PS placement prevented PEP after ERCP as compared with no PS placement. We therefore recommend PS placement after ERCP for the prevention of PEP.

Authors+Show Affiliations

Department of Surgery, Nihon University School of Medicine, 30-1 Oyaguchikami-machi, Itabashi-ku, Tokyo, 173-8610, Japan, mazaki.takero@nihon-u.ac.jp.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Meta-Analysis
Review

Language

eng

PubMed ID

23612857

Citation

Mazaki, Takero, et al. "Prophylactic Pancreatic Stent Placement and post-ERCP Pancreatitis: an Updated Meta-analysis." Journal of Gastroenterology, vol. 49, no. 2, 2014, pp. 343-55.
Mazaki T, Mado K, Masuda H, et al. Prophylactic pancreatic stent placement and post-ERCP pancreatitis: an updated meta-analysis. J Gastroenterol. 2014;49(2):343-55.
Mazaki, T., Mado, K., Masuda, H., & Shiono, M. (2014). Prophylactic pancreatic stent placement and post-ERCP pancreatitis: an updated meta-analysis. Journal of Gastroenterology, 49(2), pp. 343-55. doi:10.1007/s00535-013-0806-1.
Mazaki T, et al. Prophylactic Pancreatic Stent Placement and post-ERCP Pancreatitis: an Updated Meta-analysis. J Gastroenterol. 2014;49(2):343-55. PubMed PMID: 23612857.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prophylactic pancreatic stent placement and post-ERCP pancreatitis: an updated meta-analysis. AU - Mazaki,Takero, AU - Mado,Kazunari, AU - Masuda,Hideki, AU - Shiono,Motomi, Y1 - 2013/04/24/ PY - 2013/01/15/received PY - 2013/03/28/accepted PY - 2013/4/25/entrez PY - 2013/4/25/pubmed PY - 2014/11/15/medline SP - 343 EP - 55 JF - Journal of gastroenterology JO - J. Gastroenterol. VL - 49 IS - 2 N2 - BACKGROUND AND AIM: Pancreatitis is one of the most frequent post-endoscopic retrograde cholangiopancreatography (ERCP) complications. Previous meta-analyses show that prophylactic pancreatic stent (PS) placement after ERCP is beneficial for the prevention of post-ERCP pancreatitis (PEP). However, the results of these meta-analyses are controversial due to the limited sample size of the eligible studies, in which six additional randomized controlled trials (RCTs) are not included. Our aim is, therefore, to update the current meta-analyses regarding PS placement for prevention of PEP. METHODS: We conducted a meta-analysis to identify RCTs comparing PS placement and the subsequent incidence of PEP. The primary outcome was the incidence of PEP. RESULTS: Fourteen studies were enrolled in this meta-analysis. Of the 1,541 patients, 760 patients received a PS and 781 patients were allocated to the control group. PS placement was associated with a statistically significant reduction of PEP [relative risk (RR) 0.39; 95 % confidence interval (CI) 0.29-0.53; P < 0.001]. Subgroup analysis stratified according to the severity of PEP showed that a PS was beneficial in patients with mild to moderate PEP (RR 0.45; 95 % CI 0.32-0.62; P < 0.001) and in patients with severe PEP (RR 0.26; 95 %CI 0.09-0.76; P = 0.01). In addition, subgroup analysis performed according to patient selection demonstrated that PS placement was effective for both high-risk and mixed case groups. CONCLUSIONS: This meta-analysis showed that PS placement prevented PEP after ERCP as compared with no PS placement. We therefore recommend PS placement after ERCP for the prevention of PEP. SN - 1435-5922 UR - https://www.unboundmedicine.com/medline/citation/23612857/Prophylactic_pancreatic_stent_placement_and_post_ERCP_pancreatitis:_an_updated_meta_analysis_ L2 - https://dx.doi.org/10.1007/s00535-013-0806-1 DB - PRIME DP - Unbound Medicine ER -