Aggressive Hydration With Lactated Ringer Solution in Prevention of Postendoscopic Retrograde Cholangiopancreatography Pancreatitis A Meta-analysis of Randomized Controlled Trials
机构:[1]Department of Gastroenterology, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning Province, China外科科室胃肠外科大连医科大学附属第一医院[2]Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou, Guangdong Province其他部门华南肿瘤学国家重点实验室中山大学肿瘤防治中心
Background: Pancreatitis is the most common complication of endoscopic retrograde cholangiopancreatography (ERCP). The results of previous studies evaluating aggressive hydration with lactated Ringer solution for reducing the incidence of post-ERCP pancreatitis (PEP) are inconsistent. Aim: We performed a meta-analysis to determine whether aggressive hydration with lactated Ringer solution reduced PEP. Methods: Randomized controlled trials (RCTs) comparing aggressive hydration with standard hydration with the same lactated Ringer solution for prophylaxis of PEP were searched in PubMed, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), and CINAHL databases. ClinicalTrial.gov and International Standard Randomised Controlled Trial Number registry were also searched for unpublished studies. A meta-analysis was conducted in accordance with the Cochrane Handbook for Systemic Reviews of Intervention. Results: A total of 7 RCTs with 1047 participants were included into this meta-analysis. Meta-analysis showed that aggressive hydration reduced the incidence of PEP as compared with standard hydration [odds ratio (OR), 0.47; 95% confidence interval (CI), 0.30-0.72; P=0.0006]. Aggressive hydration also reduced the incidence of post-ERCP hyperamylasemia as compared with standard hydration (OR, 0.38; 95% CI, 0.25-0.59; P<0.00001). No difference of adverse effects was found between aggressive hydration and standard hydration (OR, 0.48; 95% CI, 0.15-1.57; P=0.23). Sensitivity analyses showed that neither alternative effect measures nor statistical models regarding heterogeneity affected the conclusions of this meta-analysis. Sensitivity analyses also showed that omitting 1 study from analysis did not change the conclusion of this meta-analysis. Conclusions: On the basis of this meta-analysis of RCTs, aggressive hydration with lactated Ringer solution is an effective and safe therapy for prophylaxis of PEP.
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外文
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出版当年[2017]版:
大类|3 区医学
小类|3 区胃肠肝病学
最新[2023]版:
大类|4 区医学
小类|4 区胃肠肝病学
第一作者:
第一作者机构:[1]Department of Gastroenterology, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning Province, China[*1]Department of Gastroenterology, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning Province, 116000 China
通讯作者:
通讯机构:[1]Department of Gastroenterology, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning Province, China[2]Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou, Guangdong Province[*1]Department of Gastroenterology, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning Province, 116000 China[*2]Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou, Guangdong Province, 510000 China
推荐引用方式(GB/T 7714):
Zhi-Feng Zhang,Zhi-Jun Duan,Li-Xia Wang,et al.Aggressive Hydration With Lactated Ringer Solution in Prevention of Postendoscopic Retrograde Cholangiopancreatography Pancreatitis A Meta-analysis of Randomized Controlled Trials[J].Journal of clinical gastroenterology.2017,51(3):E17-E26.doi:10.1097/MCG.0000000000000781.
APA:
Zhi-Feng Zhang,Zhi-Jun Duan,Li-Xia Wang,Gang Zhao&Wu-Guo Deng.(2017).Aggressive Hydration With Lactated Ringer Solution in Prevention of Postendoscopic Retrograde Cholangiopancreatography Pancreatitis A Meta-analysis of Randomized Controlled Trials.Journal of clinical gastroenterology,51,(3)
MLA:
Zhi-Feng Zhang,et al."Aggressive Hydration With Lactated Ringer Solution in Prevention of Postendoscopic Retrograde Cholangiopancreatography Pancreatitis A Meta-analysis of Randomized Controlled Trials".Journal of clinical gastroenterology 51..3(2017):E17-E26