Hidratación con Ringer Lactato combinado con diclofenaco rectal en la prevención de pancreatitis poscolangiopancreatografía retrógrada endoscópica

Martínez, M.L. del Olmo; Jiménez, Benito Velayos; Almaraz-Gómez, Ana

doi:10.1016/j.gastrohep.2020.03.014

Cited by 3 publications

(3 citation statements)

References 16 publications

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“…In the present review, all the four RCTs investigating the effect of Ringer's lactate alone in the prevention of post-ERCP pancreatitis showed that the procedure is effective with a significant statistical difference (odds ratio 0.23, 95% CI 0.13 - 0.40, P-value < 0.001) [ 12 - 15 ]. A meta-analysis conducted by Wu et al showed that Ringer's lactate aggressive hydration shortened hospital stay and reduced moderate to severe post-ERCP pancreatitis [ 16 ].…”

Section: Reviewmentioning

confidence: 90%

“…There were eight randomized controlled trials (five were from Asia [ 9 - 11 , 13 , 15 ], two from the USA [ 2 , 14 ], and one from Europe [ 12 ]) including 713 patients who received Ringer's lactate infusion alone [ 12 - 15 ] or in combination with stenting or NSAIDs [ 2 , 9 - 11 ]. All the studies showed that Ringer's lactate infusion was effective in the prevention of PEP.…”

Section: Reviewmentioning

confidence: 99%

“…A highly significant statistical difference was found between Ringer's lactate and placebo regarding the prevention of PEP (odds ratio (OR) 0.23, 95% CI 0.13 - 0.40, P-value < 0.001, I 2 for heterogeneity = 0%, P-value = 0.61, Chi-square value 1.83, degrees of freedom (df) 3) (Figure 2 ). Besides, a significant statistical difference was found between Ringer's lactate alone or in combination with other therapies regarding the prevention of post-ERCP pancreatitis (OR 0.63, 95% CI 0.41 - 0.98, P-value < 0.04, I 2 for heterogeneity = 0%, P-value = 0.48, Chi-square value 2.47, df 3) [ 12 - 15 ]. The results imply that the combination is superior (Figure 3 ).…”

Section: Reviewmentioning

confidence: 99%

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Aggressive Hydration With Ringer's Lactate in the Prevention of Post-ERCP Pancreatitis: A Meta-Analysis

Aljohani¹,

Mirghani²

2021

Cureus

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Post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) is a dangerous complication and occurs in a considerable number of patients. However, since well-randomized controlled trials investigating aggressive hydration with Ringer's lactate are lacking, this meta-analysis assessed the role of aggressive hydration with Ringer's lactate alone or in combination with other therapies in the prevention of PEP. We searched PubMed, Cochrane Library, and Google Scholar for relevant articles. The search engine was set to randomize controlled trials and prospective cohorts assessing Ringer's lactate in PEP prevention either alone or in combination with non-steroidal anti-inflammatory drugs (NSAIDs) and stent. The keywords "aggressive hydration," "Ringer's lactate," "post-ERCP pancreatitis," "NSAIDs," "stent placement," and "somatostatin analogs" were used. The search was limited to a study on humans published in English with no limitation to the study period. Two hundred and six articles were retrieved. Only eight articles fulfilled the inclusion criteria. The studies showed a reduction of post-ERCP pancreatitis using aggressive hydration with Ringer's lactate alone (odds ratio 0.23, 95% CI 0.13 - 0.40, P-value < 0.001, I 2 for heterogeneity = 0%, P-value = 0.61, Chi-square value 1.83, and degrees of freedom (df) 3. In addition, the combination of Ringer's lactate with stents or NSAIDs was superior to Ringer's lactate alone (odds ratio 0.63, 95% CI 0.41 - 0.98, P-value < 0.04, I 2 for heterogeneity = 0%, P-value = 0.48, Chi-square value 2.47, and df 3). Aggressive hydration with Ringer's lactate alone was effective in the prevention of PEP with a superior effect when combined with stents and NSAIDs.

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Section: Reviewmentioning

confidence: 90%

Section: Reviewmentioning

confidence: 99%

Section: Reviewmentioning

confidence: 99%

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Aggressive Hydration With Ringer's Lactate in the Prevention of Post-ERCP Pancreatitis: A Meta-Analysis

Aljohani¹,

Mirghani²

2021

Cureus

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Rectal nonsteroidal anti-inflammatory drugs, glyceryl trinitrate, or combinations for prophylaxis of post-endoscopic retrograde cholangiopancreatography pancreatitis: A network meta-analysis

Shi¹,

Huang²,

Li³

et al. 2022

WJCC

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BACKGROUND Acute pancreatitis is the most common and severe complication of endoscopic retrograde cholangiopancreatography (ERCP). Recent evidence suggests that combinations based on rectal nonsteroidal anti-inflammatory drugs (NSAIDs) are more beneficial in preventing post-ERCP pancreatitis (PEP). Randomized controlled trials (RCTs) have also demonstrated the efficacy of glyceryl trinitrate (GTN). We conducted a network meta-analysis to compare NSAIDs and GTN for prevention of PEP and to determine whether they are better in combination. AIM To compare NSAIDs and GTN for prevention of PEP and to determine whether they are better in combination. METHODS A systematic search was done for full-text RCTs of PEP in PubMed, Embase, Science Citation Index, and the Cochrane Controlled Trials database. Inclusion and exclusion criteria were used to screen for eligible RCTs. The major data were extracted by two independent reviewers. The frequentist model was used to conduct this network meta-analysis and obtain the pairwise OR and 95%CI. The data were then extracted and assessed on the basis of the Reference Citation Analysis ( ). RESULTS Twenty-four eligible RCTs were selected, evaluating seven preventive strategies in 9416 patients. Rectal indomethacin 100 mg plus sublingual GTN (OR: 0.21, 95%CI: 0.09–0.50), rectal diclofenac 100 mg (0.34, 0.18–0.65), sublingual GTN (0.34, 0.12–0.97), and rectal indomethacin 100 mg (0.49, 0.33–0.73) were all more efficacious than placebo in preventing PEP. The combination of rectal indomethacin and sublingual GTN had the highest surface under the cumulative ranking curves (SUCRA) probability of (92.2%) and was the best preventive strategy for moderate-to-severe PEP with a SUCRA probability of (89.2%). CONCLUSION Combination of rectal indomethacin 100 mg with sublingual GTN offered better prevention of PEP than when used alone and could alleviate the severity of PEP.

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Current approaches and questions yet to be resolved for the prophylaxis of post-endoscopic retrograde cholangiopancreatography pancreatitis

Saito¹,

Fujimoto²,

Oomoto³

et al. 2022

World J Gastrointest Endosc

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Hidratación con Ringer Lactato combinado con diclofenaco rectal en la prevención de pancreatitis poscolangiopancreatografía retrógrada endoscópica

Cited by 3 publications

References 16 publications

Aggressive Hydration With Ringer's Lactate in the Prevention of Post-ERCP Pancreatitis: A Meta-Analysis

Aggressive Hydration With Ringer's Lactate in the Prevention of Post-ERCP Pancreatitis: A Meta-Analysis

Rectal nonsteroidal anti-inflammatory drugs, glyceryl trinitrate, or combinations for prophylaxis of post-endoscopic retrograde cholangiopancreatography pancreatitis: A network meta-analysis

Current approaches and questions yet to be resolved for the prophylaxis of post-endoscopic retrograde cholangiopancreatography pancreatitis

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