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The Efficiency of Aggressive Hydration With Lactated Ringer Solution for the Prevention of Post-ERCP Pancreatitis: A Systematic Review and Meta-analysis.
J Clin Gastroenterol 2017; 51(8):e68-e76JC

Abstract

BACKGROUND

As shown in studies, aggressive hydration during the perioperative period of endoscopic retrograde cholangiopancreatography (ERCP) effectively prevents post-ERCP pancreatitis (PEP). We conducted a systematic review and meta-analysis to evaluate the clinical effectiveness and safety of aggressive hydration with lactated Ringer solution at preventing PEP.

MATERIALS AND METHODS

We searched all relevant research from PubMed, the Cochrane Library, Embase, the Web of Science, ClinicalTrial.gov, and Scopus database for randomized controlled trials (RCTs) published before March 2017. Reference lists from reviews or relevant articles were screened for RCTs. The primary outcomes were the incidence of PEP and the incidence of moderate to severe pancreatitis. The secondary outcomes were the incidence of hyperamylasemia and pain and the length of hospital stay. The meta-analysis was conducted using the Cochrane Program Review Manager.

RESULTS

Three RCTs were included in our study. On the basis of the results of the meta-analysis, the aggressive hydration group had a lower incidence of pancreatitis after ERCP [odds ratio (OR)=0.29; 95% confidence interval (CI), 0.16-0.53]; a lower incidence of moderate to severe PEP (OR=0.16; 95% CI, 0.03-0.96); lower incidence of hyperamylasemia (OR=0.38; 95% CI, 0.25-0.59); lower risk of pain (OR=0.17; 95% CI, 0.08-0.38); and a shorter duration of hospital stay (standardized mean difference=-0.41; 95% CI, -0.69 to -0.14).

CONCLUSIONS

Aggressive hydration with lactated Ringer solution can reduce the overall incidence of PEP, moderate to severe pancreatitis and hyperamylasemia, shorten the length of hospitalization and reduce pain.

Authors+Show Affiliations

Department of Gastroenterology, The First Affiliated Hospital of Nanchang University, Jiangxi, P.R. China.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Meta-Analysis
Review
Systematic Review

Language

eng

PubMed ID

28609383

Citation

Wu, Dangyan, et al. "The Efficiency of Aggressive Hydration With Lactated Ringer Solution for the Prevention of Post-ERCP Pancreatitis: a Systematic Review and Meta-analysis." Journal of Clinical Gastroenterology, vol. 51, no. 8, 2017, pp. e68-e76.
Wu D, Wan J, Xia L, et al. The Efficiency of Aggressive Hydration With Lactated Ringer Solution for the Prevention of Post-ERCP Pancreatitis: A Systematic Review and Meta-analysis. J Clin Gastroenterol. 2017;51(8):e68-e76.
Wu, D., Wan, J., Xia, L., Chen, J., Zhu, Y., & Lu, N. (2017). The Efficiency of Aggressive Hydration With Lactated Ringer Solution for the Prevention of Post-ERCP Pancreatitis: A Systematic Review and Meta-analysis. Journal of Clinical Gastroenterology, 51(8), pp. e68-e76. doi:10.1097/MCG.0000000000000856.
Wu D, et al. The Efficiency of Aggressive Hydration With Lactated Ringer Solution for the Prevention of Post-ERCP Pancreatitis: a Systematic Review and Meta-analysis. J Clin Gastroenterol. 2017;51(8):e68-e76. PubMed PMID: 28609383.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The Efficiency of Aggressive Hydration With Lactated Ringer Solution for the Prevention of Post-ERCP Pancreatitis: A Systematic Review and Meta-analysis. AU - Wu,Dangyan, AU - Wan,Jianhua, AU - Xia,Liang, AU - Chen,Jie, AU - Zhu,Yin, AU - Lu,Nonghua, PY - 2017/6/14/pubmed PY - 2018/5/2/medline PY - 2017/6/14/entrez SP - e68 EP - e76 JF - Journal of clinical gastroenterology JO - J. Clin. Gastroenterol. VL - 51 IS - 8 N2 - BACKGROUND: As shown in studies, aggressive hydration during the perioperative period of endoscopic retrograde cholangiopancreatography (ERCP) effectively prevents post-ERCP pancreatitis (PEP). We conducted a systematic review and meta-analysis to evaluate the clinical effectiveness and safety of aggressive hydration with lactated Ringer solution at preventing PEP. MATERIALS AND METHODS: We searched all relevant research from PubMed, the Cochrane Library, Embase, the Web of Science, ClinicalTrial.gov, and Scopus database for randomized controlled trials (RCTs) published before March 2017. Reference lists from reviews or relevant articles were screened for RCTs. The primary outcomes were the incidence of PEP and the incidence of moderate to severe pancreatitis. The secondary outcomes were the incidence of hyperamylasemia and pain and the length of hospital stay. The meta-analysis was conducted using the Cochrane Program Review Manager. RESULTS: Three RCTs were included in our study. On the basis of the results of the meta-analysis, the aggressive hydration group had a lower incidence of pancreatitis after ERCP [odds ratio (OR)=0.29; 95% confidence interval (CI), 0.16-0.53]; a lower incidence of moderate to severe PEP (OR=0.16; 95% CI, 0.03-0.96); lower incidence of hyperamylasemia (OR=0.38; 95% CI, 0.25-0.59); lower risk of pain (OR=0.17; 95% CI, 0.08-0.38); and a shorter duration of hospital stay (standardized mean difference=-0.41; 95% CI, -0.69 to -0.14). CONCLUSIONS: Aggressive hydration with lactated Ringer solution can reduce the overall incidence of PEP, moderate to severe pancreatitis and hyperamylasemia, shorten the length of hospitalization and reduce pain. SN - 1539-2031 UR - https://www.unboundmedicine.com/medline/citation/28609383/The_Efficiency_of_Aggressive_Hydration_With_Lactated_Ringer_Solution_for_the_Prevention_of_Post_ERCP_Pancreatitis:_A_Systematic_Review_and_Meta_analysis_ L2 - http://Insights.ovid.com/pubmed?pmid=28609383 DB - PRIME DP - Unbound Medicine ER -