Tags

Type your tag names separated by a space and hit enter

Incidence, severity, and mortality of post-ERCP pancreatitis: a systematic review by using randomized, controlled trials.
Gastrointest Endosc 2015; 81(1):143-149.e9GE

Abstract

BACKGROUND

Data regarding the incidence and severity of post-ERCP pancreatitis (PEP) are primarily from nonrandomized studies.

OBJECTIVE

To determine the incidence, severity, and mortality of PEP from a systematic review of the placebo or no-stent arms of randomized, controlled trials (RCTs).

DESIGN

MEDLINE, EMBASE, and Cochrane databases were searched to identify RCTs evaluating the efficacy of drugs and/or pancreatic stents to prevent PEP.

SETTING

Systematic review of patients enrolled in RCTs evaluating agents for PEP prophylaxis.

PATIENTS

Patients in the placebo or no-stent arms of the RCTs

INTERVENTION

ERCP.

MAIN OUTCOME MEASUREMENTS

Incidence, severity, and mortality of PEP.

RESULTS

There were 108 RCTs with 13,296 patients in the placebo or no-stent arms. Overall, the PEP incidence was 9.7% and the mortality rate was 0.7%. Severity of PEP was reported for 8857 patients: 5.7%, 2.6%, and 0.5% of cases were mild, moderate, and severe, respectively. The incidence of PEP in 2345 high-risk patients was 14.7% and the severity of PEP was mild, moderate, and severe in 8.6%, 3.9%, and 0.8%, respectively, with a 0.2% mortality rate. The incidence of PEP was 13% in North American RCTs compared with 8.4% in European and 9.9% in Asian RCTs. ERCPs conducted before and after 2000 had a PEP incidence of 7.7% and 10%, respectively.

LIMITATIONS

Difference in PEP risk among patients in the included RCTs.

CONCLUSION

The incidence of PEP and severe PEP is similar in high-risk patients and the overall cohort. Discrepancies in the incidence of PEP across geographic regions require further study.

Authors+Show Affiliations

Department of Medicine, The Johns Hopkins Hospital, Baltimore, Maryland, USA.Division of Gastroenterology, The Johns Hopkins Hospital, Baltimore, Maryland, USA.Division of Gastroenterology, The Johns Hopkins Hospital, Baltimore, Maryland, USA.Division of Gastroenterology, University of Michigan Medical Center, Ann Arbor, Michigan, USA.Division of Gastroenterology, The Johns Hopkins Hospital, Baltimore, Maryland, USA.Division of Gastroenterology, The Johns Hopkins Hospital, Baltimore, Maryland, USA.Division of Gastroenterology, The Johns Hopkins Hospital, Baltimore, Maryland, USA.Division of Gastroenterology, The Johns Hopkins Hospital, Baltimore, Maryland, USA.Division of Gastroenterology, The Johns Hopkins Hospital, Baltimore, Maryland, USA.

Pub Type(s)

Journal Article
Review
Systematic Review

Language

eng

PubMed ID

25088919

Citation

Kochar, Bharati, et al. "Incidence, Severity, and Mortality of post-ERCP Pancreatitis: a Systematic Review By Using Randomized, Controlled Trials." Gastrointestinal Endoscopy, vol. 81, no. 1, 2015, pp. 143-149.e9.
Kochar B, Akshintala VS, Afghani E, et al. Incidence, severity, and mortality of post-ERCP pancreatitis: a systematic review by using randomized, controlled trials. Gastrointest Endosc. 2015;81(1):143-149.e9.
Kochar, B., Akshintala, V. S., Afghani, E., Elmunzer, B. J., Kim, K. J., Lennon, A. M., ... Singh, V. K. (2015). Incidence, severity, and mortality of post-ERCP pancreatitis: a systematic review by using randomized, controlled trials. Gastrointestinal Endoscopy, 81(1), pp. 143-149.e9. doi:10.1016/j.gie.2014.06.045.
Kochar B, et al. Incidence, Severity, and Mortality of post-ERCP Pancreatitis: a Systematic Review By Using Randomized, Controlled Trials. Gastrointest Endosc. 2015;81(1):143-149.e9. PubMed PMID: 25088919.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Incidence, severity, and mortality of post-ERCP pancreatitis: a systematic review by using randomized, controlled trials. AU - Kochar,Bharati, AU - Akshintala,Venkata S, AU - Afghani,Elham, AU - Elmunzer,B Joseph, AU - Kim,Katherine J, AU - Lennon,Anne Marie, AU - Khashab,Mouen A, AU - Kalloo,Anthony N, AU - Singh,Vikesh K, Y1 - 2014/08/01/ PY - 2013/12/26/received PY - 2014/06/26/accepted PY - 2014/8/5/entrez PY - 2014/8/5/pubmed PY - 2015/8/19/medline SP - 143 EP - 149.e9 JF - Gastrointestinal endoscopy JO - Gastrointest. Endosc. VL - 81 IS - 1 N2 - BACKGROUND: Data regarding the incidence and severity of post-ERCP pancreatitis (PEP) are primarily from nonrandomized studies. OBJECTIVE: To determine the incidence, severity, and mortality of PEP from a systematic review of the placebo or no-stent arms of randomized, controlled trials (RCTs). DESIGN: MEDLINE, EMBASE, and Cochrane databases were searched to identify RCTs evaluating the efficacy of drugs and/or pancreatic stents to prevent PEP. SETTING: Systematic review of patients enrolled in RCTs evaluating agents for PEP prophylaxis. PATIENTS: Patients in the placebo or no-stent arms of the RCTs INTERVENTION: ERCP. MAIN OUTCOME MEASUREMENTS: Incidence, severity, and mortality of PEP. RESULTS: There were 108 RCTs with 13,296 patients in the placebo or no-stent arms. Overall, the PEP incidence was 9.7% and the mortality rate was 0.7%. Severity of PEP was reported for 8857 patients: 5.7%, 2.6%, and 0.5% of cases were mild, moderate, and severe, respectively. The incidence of PEP in 2345 high-risk patients was 14.7% and the severity of PEP was mild, moderate, and severe in 8.6%, 3.9%, and 0.8%, respectively, with a 0.2% mortality rate. The incidence of PEP was 13% in North American RCTs compared with 8.4% in European and 9.9% in Asian RCTs. ERCPs conducted before and after 2000 had a PEP incidence of 7.7% and 10%, respectively. LIMITATIONS: Difference in PEP risk among patients in the included RCTs. CONCLUSION: The incidence of PEP and severe PEP is similar in high-risk patients and the overall cohort. Discrepancies in the incidence of PEP across geographic regions require further study. SN - 1097-6779 UR - https://www.unboundmedicine.com/medline/citation/25088919/Incidence_severity_and_mortality_of_post_ERCP_pancreatitis:_a_systematic_review_by_using_randomized_controlled_trials_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0016-5107(14)01936-1 DB - PRIME DP - Unbound Medicine ER -