Systematic review and meta-analysis on the prophylacticrole of non-steroidal anti-inflammatory drugs to preventpost-endoscopic retrograde cholangiopancreatographypancreatitis

• 作者: Amir H Khawaja Krishna K Singh Mazin Sayegh Muhammad S Sajid Zinu Philipose
• 来源期刊: 世界胃肠内镜杂志：英文版（电子版）
• 学科: 医学
• 关键词: NON-STEROIDAL drugs PANCREATITIS DICLOFENAC INDOMETHACIN Endoscopic RETROGRADE CHOLANGIOPANCREATOGRAPHY
• 年，卷（期）: 2015,（19）
• 页码范围: 1341-1349
• 页数: 9页
• 分类号: R

摘要

AIM To critically appraise the published randomized,controlled trials on the prophylactic effectiveness ofthe non-steroidal anti-inflammatory drugs （NSAIDs）,in reducing the risk of post-endoscopic retrogradecholangiopancreatography （ERCP） pancreatitis.METHODS： A systematic literature search （MEDLINE,Embase and the Cochrane Library, from inception of thedatabases until May 2015） was conducted to identifyrandomized, clinical trials investigating the role ofNSAIDs in reducing the risk of post-ERCP pancreatitis.Random effects model of the meta-analysis was carriedout, and results were presented as odds ratios （OR）with corresponding 95%CI.RESULTS： Thirteen randomized controlled trials on3378 patients were included in the final meta-analysis.There were 1718 patients in the NSAIDs group and 1660patients in non-NSAIDs group undergoing ERCP. Theuse of NSAIDs （through rectal route or intramuscularroute） was associated with the reduced risk of post-ERCPpancreatitis [OR, 0.52 （0.38-0.72）, P = 0.0001]. Theuse of pre-procedure NSAIDs was effective in reducingapproximately 48% incidence of post-ERCP pancreatitis,number needed to treat were 16 with absolute riskreduction of 0.05. But the risk of post-ERCP pancreattiswas reduced by 55% if NSAIDs were administered afterprocedure. Similarly, diclofenac was more effective （55%）prophylactic agent compared to indomethacin （41%）.CONCLUSION： NSAIDs seem to have clinically provenadvantage of reducing the risk of post-ERCP pancreatitis.