Aggressive Intravenous Hydration With Lactated Ringer's Solution Reduces the Development of Post-Ercp Pancreatitis

Alcivar-Leon, Marcelo; Serrano-Suarez, Andres; Carrillo-Ubidia, Javier; Alba, ML Jara; Marriott-Blum, D; Frugone-Morla, Luis; Nieto-Orellana, Ivan; Mönkemüller, Klaus; Marriott-Diaz, Eduardo

doi:10.1055/s-0038-1637102

Cited by 1 publication

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“…Ten randomized controlled trials [ 21 – 30 ] were included in this meta analyses. Of the 10 RCTs, two studies were in USA, [ 21 , 22 ] two were in Korea, [ 23 , 24 ] one study was in Ecuador [ 25 ] two studies were in Iran, [ 26 , 27 ] one study was in Portugal, [ 28 ] and two studies were in Thailand. [ 29 , 30 ] The 5 of 10 RCTs were published as full text articles, 4 RCTs were published as abstract, and one study [ 21 ] was available at: https://clinicaltrials.gov/show/NCT02050048 Accessed June 26, 2016.…”

Section: Resultsmentioning

confidence: 99%

“…Four studies [ 23 , 24 , 28 , 30 ] were double-blinded studies. 4 studies [ 22 , 25 – 27 ] were single-blinded studies. The assessment of the risk of bias of included studies was illustrated in Figure 2 .…”

Section: Resultsmentioning

confidence: 99%

“…In the first group [ 21 – 25 , 27 , 28 , 30 ] , the onset of fluid therapy was during the ERCP procedure, while in the second group, [ 26 , 29 ] the initial bolus of lactated Ringer solution was before ERCP procedure. It was found that aggressive hydration had a significant effect on reducing the incidence of PEP ( I 2 = 6%; OR, 0.31; 95% CI, 0.19–0.53; P < .00001, random model) in the first group.…”

Section: Resultsmentioning

confidence: 99%

“…Four studies [ 21 – 25 , 29 , 30 ] including 478 patients compared the incidence of abdominal pain between aggressive hydration and standard hydration during and after ERCP. Heterogeneity was detected in these studies so a random model was established to synthesize data by using Mantel Hansel method.…”

Section: Resultsmentioning

confidence: 99%

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Aggressive hydration with lactated ringer solution in prevention of post-endoscopic retrograde cholangiopancreatography pancreatitis

Jiang

et al. 2021

Medicine

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Background: Acute pancreatitis is the most common complication of Endoscopic Retrograde Cholangiopancreatography (ERCP). There was no conclusion on the prevention of Post-ERCP Pancreatitis (PEP) by Lactated Ringer Solution. Aim: The purpose of this meta analyses is to determine whether aggressive hydration with Lactated Ringer Solution reduced the incidence of PEP. Methods: We retrieved randomized clinical trials comparing the preventive effects of aggressive hydration with Lactated Ringer Solution and standard hydration on PEP from PubMed, the Cochrane Library, Embase, the Web of Science, Clinical Trial.gov, Scopus database, CNKI, CQVIP and WanFang Data. Primary outcome was incidence of PEP. Secondary outcomes included incidence of hyperamylasemia, abdominal pain and adverse events. Results: Ten randomized controlled trials with 2200 patients were included in this meta-analysis. Meta-analysis showed that compared with standard hydration, aggressive hydration reduced the incidence of PEP (odds ratio [OR], 0.40; 95% confidence intervals [CI], 0.26–0.63; P < .0001). Compared with standard hydration, aggressive hydration also reduced the incidence of hyperamylasemia after ERCP (OR, 0.48; 95% CI, 0.38–0.60; P < .0001). There was significant difference between aggressive hydration and standard hydration in the incidence of abdominal pain (OR, 0.29; 95% CI, 0.11–0.73; P = .008). There was no difference in adverse events between aggressive hydration and standard hydration (OR, 0.93; 95% CI, 0.21–4.13; P = .93). Sensitivity analyses showed that neither alternative effect measures nor statistical models regarding heterogeneity affected the conclusions of this meta-analysis. Conclusion: Aggressive hydration with Lactated Ringer Solution during perioperative period of ERCP can prevent PEP.

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