Does endoscopic retrograde cholangiopancreatography reduce the risk of local pancreatic complications in acute pancreatitis? A systematic review and metaanalysis

Abstract

The early use of ERCP did not result in a significantly reduced risk of local pancreatic complications for either patients with mild acute pancreatitis or those with severe form of the disease.

Does presence of common bile duct stones in patients with acute biliary pancreatitis affect the severity of illness or laboratory findings?

“…Our findings did not support that the presence of stone in the CBD or ampulla has an effect on the severity of pancreatitis. Our findings are consistent with the studies suggesting that the persistence of main bile duct stones does not by itself contribute to the worsening or persistence of pancreatic inflammation (7,15,34).…”

Systematic review of endoscopic ultrasonography versus endoscopic retrograde cholangiopancreatography for suspected choledocholithiasis

“…As there was no difference between the groups with regard to the risk of complications per ERCP procedure, the observed risk reduction is probably due to the avoidance of ERCPs in 67·1 per cent of patients in the EUS-guided ERCP group. It is worth noting that, although relatively rare events, ERCP-related complications may be life threatening 19,20 . However, 38·5 per cent (82 of 213) of patients in the EUS-guided ERCP group needed at least one additional endoscopic procedure.…”

Nutrition, Inflammation, and Acute Pancreatitis

“…Sixteen publications were subsequently excluded: four were on refeeding in patients with acute pancreatitis, four were republished in a non-English language, three were conducted in patients with acute pancreatitis after surgery, two compared nasogastric and nasojejunal routes of enteral nutrition, two studied enteral nutrition supplemented with parenteral nutrition, and one used the same study population as in another included randomised controlled trial. Thus, a total of 20 randomised controlled trials met all the inclusion criteria [32, 33, 36, 41, 43, 46, 62, 70–73, 75, 93–104]. All included articles were published in peer-reviewed journals.…”

“…The 20 randomised controlled trials comprised a total of 1070 patients with acute pancreatitis (825 with predicted severe and 245 with predicted mild course of acute pancreatitis) [32, 33, 36, 41, 43, 46, 62, 70–73, 75, 93–104]. Twelve studies were limited to patients with predicted severe acute pancreatitis only.…”