Meta-analysis of prophylactic corticosteroid use in post-ERCP pancreatitis

Zheng, Ming‐Hua; Bai, Jianling; Yuan, Bo; Lin, Feng; You, Jie; Lu, Mingqin; Gong, Yuewen; Chen, Yongping

doi:10.1186/1471-230x-8-6

Cited by 44 publications

(39 citation statements)

References 36 publications

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“…44,45 However, in those studies, the effect of a single or double dose of steroids was analyzed. In our series, we found prednisone therapy to be protective of the development of ERCP complications (mainly pancreatitis), perhaps because of the fact that patients were on long-term therapy.…”

Section: Discussionmentioning

confidence: 99%

Complications after ERCP in liver transplant recipients

Balderramo

Bordas

Sendino

et al. 2011

Gastrointestinal Endoscopy

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Section: Discussionmentioning

confidence: 99%

Complications after ERCP in liver transplant recipients

Balderramo

Bordas

Sendino

et al. 2011

Gastrointestinal Endoscopy

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“…Recently, a metaanalysis by Elmunzer et al [7] revealed that prophylactic rectal NSAIDs were effective in preventing PEP. However, meta-analyses of somatostatin or gabexate [8], octreotide [9], steroids [10], and allopurinol [11] failed to demonstrate positive effects of these drugs in the prevention of PEP. To date, no pharmacological prophylaxis for PEP is in widespread clinical use.…”

Section: Introductionmentioning

confidence: 94%

Nitroglycerin in the Prevention of Post-ERCP Pancreatitis: A Meta-Analysis

Shao

Chen

et al. 2009

Dig Dis Sci

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The objective of this research paper is to evaluate the effect of prophylactic nitroglycerin in the prevention of post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) by performing a meta-analysis of randomized controlled trials (RCTs). Electronic databases, including PubMed, EMBASE, the Cochrane library, and the Science Citation Index, were searched to retrieve relevant trials. Outcome measures were the incidence of PEP. Four RCTs, enrolling a total of 856 patients, were included. Meta-analysis of these trials indicated a significant association between the use of nitroglycerin and the reduction of PEP (RR 0.60; 95%CI: 0.39-0.92; P = 0.02). However, subsequent sensitive analysis failed to confirm that nitroglycerin was statistically superior to a placebo in reducing PEP (RR 0.68; 95%CI: 0.41-1.11; P = 0.12). Based on the limitations in this meta-analysis, prophylactic use of nitroglycerine for all patients who underwent ERCP is not recommended. Further clinical trials are required to confirm the effect of nitroglycerin in the prevention of PEP.

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“…Dexamethasone can also lower amylase, endotoxin and TNF-␣ levels and decrease the mortality caused by severe pancreatitis in rats [30] . On the other hand, prophylactic usage of corticosteroids has no effect on pancreatitis caused by endoscopic retrograde cholangiopancreatography (ERCP), and is not recommended [31] . Pentoxifylline, a methyl xanthine derivative with rheologic and anti-inflammatory properties, inhibits the production of proinflammatory cytokines.…”

Section: Discussionmentioning

confidence: 99%

Effect of Mycophenolate Mofetil on Cerulein-Induced Acute Pancreatitis

Taşdoğan¹,

Kucuk²,

Kurt³

et al. 2010

Eur Surg Res

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Aim: The aim of this study was to determine the effects of mycophenolate mofetil (MMF) on acute pancreatitis with evaluation of biochemical and histopathological findings. Materials and Methods: Cerulein was administered to induce acute pancreatitis in rats. Three groups of 10 rats each were formed. Animals in group 1 received physiologic saline solution. In group 2 animals received MMF at a dose of 14 mg/kg and group 3 had double doses of MMF. Alanine aminostransferase, aspartate aminotransferase (AST), amylase and bilirubin levels were assessed. Pancreatic tissues were evaluated under light microscopy for the presence of edema, acinar necrosis, hemorrhage, inflammation and perivascular infiltration. Results: Amylase, serum AST, edema and inflammatory infiltration levels differed between groups (amylase: p = 0.0001, serum AST: p = 0.001, edema: p = 0.0001 and inflammatory infiltration: p = 0.002), group 1 showing the highest amylase, serum AST and edema levels. The lowest levels of edema were found in group 3. Conclusion: In an experimental pancreatitis model in rats, MMF proved to exert a beneficial effect on biochemical and histopathological parameters.

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Meta-analysis of prophylactic corticosteroid use in post-ERCP pancreatitis

Cited by 44 publications

References 36 publications

Complications after ERCP in liver transplant recipients

Complications after ERCP in liver transplant recipients

Nitroglycerin in the Prevention of Post-ERCP Pancreatitis: A Meta-Analysis

Effect of Mycophenolate Mofetil on Cerulein-Induced Acute Pancreatitis

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