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Effect of somatostatin on prevention of post-endoscopic retrograde cholangiopancreatography pancreatitis and hyperamylasemia: A systematic review and meta-analysis.
Pancreatology 2018; 18(4):370-378P

Abstract

OBJECTIVE

To perform a meta-analysis of all available studies on the effect of prophylactic somatostatin administration on prevention of post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) and post-ERCP hyperamylasemia (PEHA).

METHODS

Electronic databases, including PubMed, EMBASE, the Cochrane library, and the Science Citation Index were searched to retrieve relevant trials. Randomized, placebo-controlled trials in adult patients that compared somatostatin versus placebo in prevention of PEP were included. Meta-analysis was performed using a random-effects model to assess the ratios of PEP, PEHA and post-ERCP abdominal pain.

RESULTS

Total ratio of PEP of somatostatin group was significantly lower than that of placebo group. For the short-term injection or bolus injection there were no heterogeneity and no significance between the ratio of PEP of somatostatin group and placebo group. For the long-term injection subgroup there was heterogeneity, and the ratio of PEP of somatostatin group was significantly lower than that of placebo group. There was no significance between the ratio of PEP of somatostatin group and placebo group for the low-risk PEP subgroup, while the ratio of PEP of somatostatin group was significantly lower than that of placebo group for the high-risk PEP subgroup. The ratio of PEP of somatostatin group was significantly lower than that of placebo group for the long-term injection high-risk PEP subgroup. There was no significance between the ratio of PEHA of somatostatin group and placebo group for the short-term injection subgroup or bolus injection subgroup. The ratio of PEHA of somatostatin group was significantly lower than that of placebo group for the long-term injection subgroup. The total ratio of post-ERCP abdominal pain of somatostatin group was significantly lower than that of placebo group. The funnel plot of incidence of PEP and PEHA showed no asymmetry with a negative slope.

CONCLUSION

Prophylactic use of long-term injection of somatostatin can significantly reduce the incidence of PEP, PEHA and post-ERCP abdominal pain for the high-risk PEP patients, while it is not necessary to be used for the low-risk PEP patients.

Authors+Show Affiliations

Department of Digestive Internal Medicine, Gannan Medical University Pingxiang Hospital, 128 Guangchang Road, Pingxiang, 337055, People's Republic of China; Department of International School of Nursing, Hainan Medical University, Haikou, 571199, People's Republic of China.Department of International School of Nursing, Hainan Medical University, Haikou, 571199, People's Republic of China; Laboratory of Shock, Department of Pathophysiology, Xiangya School of Medicine, Central South University, Changsha, Hunan, 410008, People's Republic of China.Department of Digestive Internal Medicine, Gannan Medical University Pingxiang Hospital, 128 Guangchang Road, Pingxiang, 337055, People's Republic of China.Department of Digestive Internal Medicine, Gannan Medical University Pingxiang Hospital, 128 Guangchang Road, Pingxiang, 337055, People's Republic of China.Laboratory of Shock, Department of Pathophysiology, Xiangya School of Medicine, Central South University, Changsha, Hunan, 410008, People's Republic of China.Department of International School of Nursing, Hainan Medical University, Haikou, 571199, People's Republic of China.Department of Digestive Internal Medicine, Gannan Medical University Pingxiang Hospital, 128 Guangchang Road, Pingxiang, 337055, People's Republic of China.Department of Digestive Internal Medicine, Gannan Medical University Pingxiang Hospital, 128 Guangchang Road, Pingxiang, 337055, People's Republic of China.Laboratory of Shock, Department of Pathophysiology, Xiangya School of Medicine, Central South University, Changsha, Hunan, 410008, People's Republic of China. Electronic address: csxianzhongxiao@126.com.

Pub Type(s)

Journal Article
Meta-Analysis
Review
Systematic Review

Language

eng

PubMed ID

29550097

Citation

Wang, Guiliang, et al. "Effect of Somatostatin On Prevention of Post-endoscopic Retrograde Cholangiopancreatography Pancreatitis and Hyperamylasemia: a Systematic Review and Meta-analysis." Pancreatology : Official Journal of the International Association of Pancreatology (IAP) ... [et Al.], vol. 18, no. 4, 2018, pp. 370-378.
Wang G, Xiao G, Xu L, et al. Effect of somatostatin on prevention of post-endoscopic retrograde cholangiopancreatography pancreatitis and hyperamylasemia: A systematic review and meta-analysis. Pancreatology. 2018;18(4):370-378.
Wang, G., Xiao, G., Xu, L., Qiu, P., Li, T., Wang, X., ... Xiao, X. (2018). Effect of somatostatin on prevention of post-endoscopic retrograde cholangiopancreatography pancreatitis and hyperamylasemia: A systematic review and meta-analysis. Pancreatology : Official Journal of the International Association of Pancreatology (IAP) ... [et Al.], 18(4), pp. 370-378. doi:10.1016/j.pan.2018.03.002.
Wang G, et al. Effect of Somatostatin On Prevention of Post-endoscopic Retrograde Cholangiopancreatography Pancreatitis and Hyperamylasemia: a Systematic Review and Meta-analysis. Pancreatology. 2018;18(4):370-378. PubMed PMID: 29550097.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effect of somatostatin on prevention of post-endoscopic retrograde cholangiopancreatography pancreatitis and hyperamylasemia: A systematic review and meta-analysis. AU - Wang,Guiliang, AU - Xiao,Gui, AU - Xu,Linfang, AU - Qiu,Ping, AU - Li,Ting, AU - Wang,Xiaoli, AU - Wen,Ping, AU - Wen,Jianbo, AU - Xiao,Xianzhong, Y1 - 2018/03/10/ PY - 2017/12/26/received PY - 2018/02/22/revised PY - 2018/03/09/accepted PY - 2018/3/20/pubmed PY - 2018/11/8/medline PY - 2018/3/19/entrez KW - Endoscopic retrograde cholangiopancreatography KW - Hyperamylasemia KW - Pancreatitis KW - Somatostatin SP - 370 EP - 378 JF - Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.] JO - Pancreatology VL - 18 IS - 4 N2 - OBJECTIVE: To perform a meta-analysis of all available studies on the effect of prophylactic somatostatin administration on prevention of post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) and post-ERCP hyperamylasemia (PEHA). METHODS: Electronic databases, including PubMed, EMBASE, the Cochrane library, and the Science Citation Index were searched to retrieve relevant trials. Randomized, placebo-controlled trials in adult patients that compared somatostatin versus placebo in prevention of PEP were included. Meta-analysis was performed using a random-effects model to assess the ratios of PEP, PEHA and post-ERCP abdominal pain. RESULTS: Total ratio of PEP of somatostatin group was significantly lower than that of placebo group. For the short-term injection or bolus injection there were no heterogeneity and no significance between the ratio of PEP of somatostatin group and placebo group. For the long-term injection subgroup there was heterogeneity, and the ratio of PEP of somatostatin group was significantly lower than that of placebo group. There was no significance between the ratio of PEP of somatostatin group and placebo group for the low-risk PEP subgroup, while the ratio of PEP of somatostatin group was significantly lower than that of placebo group for the high-risk PEP subgroup. The ratio of PEP of somatostatin group was significantly lower than that of placebo group for the long-term injection high-risk PEP subgroup. There was no significance between the ratio of PEHA of somatostatin group and placebo group for the short-term injection subgroup or bolus injection subgroup. The ratio of PEHA of somatostatin group was significantly lower than that of placebo group for the long-term injection subgroup. The total ratio of post-ERCP abdominal pain of somatostatin group was significantly lower than that of placebo group. The funnel plot of incidence of PEP and PEHA showed no asymmetry with a negative slope. CONCLUSION: Prophylactic use of long-term injection of somatostatin can significantly reduce the incidence of PEP, PEHA and post-ERCP abdominal pain for the high-risk PEP patients, while it is not necessary to be used for the low-risk PEP patients. SN - 1424-3911 UR - https://www.unboundmedicine.com/medline/citation/29550097/Effect_of_somatostatin_on_prevention_of_post_endoscopic_retrograde_cholangiopancreatography_pancreatitis_and_hyperamylasemia:_A_systematic_review_and_meta_analysis_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1424-3903(18)30040-1 DB - PRIME DP - Unbound Medicine ER -