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Aggressive hydration compared to standard hydration with lactated ringer's solution for prevention of post endoscopic retrograde cholangiopancreatography pancreatitis.
Surg Endosc. 2020 Mar 05 [Online ahead of print]SE

Abstract

BACKGROUND AND AIMS

Previous studies have suggested that aggressive hydration with lactated ringer solution are one of the protective factors in preventing post endoscopic retrograde cholangiopancreatography (post-ERCP). We conducted a systematic review and meta-analysis to examine the efficacy aggressive hydration with lactated Ringer solution in preventing PEP.

METHODS

All published and unpublished articles on aggressive hydration with lactated ringer solution in those underwent ERCP procedure for any reasons were screened for eligibility. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. This paper doesn't need the IRB approval.

RESULTS

Seven RCTs met the inclusion criteria. Meta-analysis indicates that aggressive hydration with lactated Ringer solution were associated with lower PEP rate.[odds ratio (OR) 0.29; 95% confidence interval (CI) 0.18-0.48]; lower incidence of hyperamylasemia (OR 0.49; 95% CI 0.35, 0.69) and lower risk of pain (OR 0.28; 95% CI 0.10-0.81). The association between aggressive hydration with lactated Ringer solution and incidence of moderate severity PEP were unclear (OR 0.57; 95% CI 0.22, 1.45). Sensitivity analyses also showed that omitting 1 study from analysis of PEP rate could reduce the heterogeneity but did not change the conclusion of this meta-analysis. A cumulating meta-analysis was performed statistically which showed a stable result of overall incidence of PEP.

CONCLUSIONS

Aggressive hydration with lactated Ringer solution was a protective factor in reducing the overall incidence of PEP, hyperamylasemia and risk of abdominal pain.

Authors+Show Affiliations

Department of Gastrointestinal Surgery, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120, People's Republic of China.Department of Gastrointestinal Surgery, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120, People's Republic of China.Department of Gastrointestinal Surgery, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120, People's Republic of China.Department of Gastrointestinal Surgery, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120, People's Republic of China. hychenjs@126.com.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32140860

Citation

Wang, Rong-Chang, et al. "Aggressive Hydration Compared to Standard Hydration With Lactated Ringer's Solution for Prevention of Post Endoscopic Retrograde Cholangiopancreatography Pancreatitis." Surgical Endoscopy, 2020.
Wang RC, Jiang ZK, Xie YK, et al. Aggressive hydration compared to standard hydration with lactated ringer's solution for prevention of post endoscopic retrograde cholangiopancreatography pancreatitis. Surg Endosc. 2020.
Wang, R. C., Jiang, Z. K., Xie, Y. K., & Chen, J. S. (2020). Aggressive hydration compared to standard hydration with lactated ringer's solution for prevention of post endoscopic retrograde cholangiopancreatography pancreatitis. Surgical Endoscopy. https://doi.org/10.1007/s00464-020-07477-9
Wang RC, et al. Aggressive Hydration Compared to Standard Hydration With Lactated Ringer's Solution for Prevention of Post Endoscopic Retrograde Cholangiopancreatography Pancreatitis. Surg Endosc. 2020 Mar 5; PubMed PMID: 32140860.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Aggressive hydration compared to standard hydration with lactated ringer's solution for prevention of post endoscopic retrograde cholangiopancreatography pancreatitis. AU - Wang,Rong-Chang, AU - Jiang,Ze-Kun, AU - Xie,Ying-Kang, AU - Chen,Jing-Song, Y1 - 2020/03/05/ PY - 2019/09/29/received PY - 2020/02/26/accepted PY - 2020/3/7/entrez KW - Aggressive hydration KW - Efficacy KW - Post-ERCP pancreatitis KW - Ringer solution JF - Surgical endoscopy JO - Surg Endosc N2 - BACKGROUND AND AIMS: Previous studies have suggested that aggressive hydration with lactated ringer solution are one of the protective factors in preventing post endoscopic retrograde cholangiopancreatography (post-ERCP). We conducted a systematic review and meta-analysis to examine the efficacy aggressive hydration with lactated Ringer solution in preventing PEP. METHODS: All published and unpublished articles on aggressive hydration with lactated ringer solution in those underwent ERCP procedure for any reasons were screened for eligibility. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. This paper doesn't need the IRB approval. RESULTS: Seven RCTs met the inclusion criteria. Meta-analysis indicates that aggressive hydration with lactated Ringer solution were associated with lower PEP rate.[odds ratio (OR) 0.29; 95% confidence interval (CI) 0.18-0.48]; lower incidence of hyperamylasemia (OR 0.49; 95% CI 0.35, 0.69) and lower risk of pain (OR 0.28; 95% CI 0.10-0.81). The association between aggressive hydration with lactated Ringer solution and incidence of moderate severity PEP were unclear (OR 0.57; 95% CI 0.22, 1.45). Sensitivity analyses also showed that omitting 1 study from analysis of PEP rate could reduce the heterogeneity but did not change the conclusion of this meta-analysis. A cumulating meta-analysis was performed statistically which showed a stable result of overall incidence of PEP. CONCLUSIONS: Aggressive hydration with lactated Ringer solution was a protective factor in reducing the overall incidence of PEP, hyperamylasemia and risk of abdominal pain. SN - 1432-2218 UR - https://www.unboundmedicine.com/medline/citation/32140860/Aggressive_hydration_compared_to_standard_hydration_with_lactated_ringer's_solution_for_prevention_of_post_endoscopic_retrograde_cholangiopancreatography_pancreatitis_ L2 - https://doi.org/10.1007/s00464-020-07477-9 DB - PRIME DP - Unbound Medicine ER -
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