Pancreatic Stent Placement for Prevention of Post-ERCP Pancreatitis in High-Risk Patients: A Systematic Review and Meta-Analysis

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Tipo de produção
article
Data de publicação
2019
Título da Revista
ISSN da Revista
Título do Volume
Editora
E S BURIONI RICERCHE BIBLIOGRAFICHE
Autor de Grupo de pesquisa
Citação
JOURNAL OF THE PANCREAS, v.20, n.1, p.16-23, 2019
Projetos de Pesquisa
Unidades Organizacionais
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Resumo
Background and Aims Acute pancreatitis is one common and severe complication after endoscopic retrograde cholangiopancreatography. Randomized controlled trials have reported that pancreatic stenting may efficiently prevent post-ERCP pancreatitis. Methods Systematic review was conducted on MEDLINE/PubMed and other databases randomized controlled trials comparing patients undergoing endoscopic retrograde cholangiopancreatography with pancreatic stent versus endoscopic retrograde cholangiopancreatography without stent. Two independent reviewers assessed the eligibility. Primary outcome is to assess the degree of severity of pancreatitis (mild, moderate, and severe) and secondary hyperamylasemia, cholangitis, abdominal pain, duration of endoscopic retrograde cholangiopancreatography and length of hospital stay. Results Twelve randomized controlled trials selected a total of 3.310 patients. Meta-analysis showed that pancreatic stenting reduced pancreatitis risk to PEP (mild PEP: RD 0.06, 95% CI-0.09 - 0.03; moderate PEP: RD 0.03, 95 % CI-0.06 - 0.01; severe PEP: (RD 0.02, 95% CI-0.05-0.01); Hyperaylasemia (RD-0.62, 95% CI-0.65-0.59) showed statistically significant difference. Cholangitis (RD 0.03, 95% CI-0.03-0.09), abdominal pain (RD 0.10, 95% CI-0.21-0.01), length of hospital stay after ERCP (RD 1.55, 95% CI-4.39 - 1.29), total duration of the procedure (RD 2.97, 95% CI-0.19-6.12), showed no statistical significance. Conclusions Pancreatic stent placement is effective in reducing post-endoscopic retrograde cholangiopancreatography acute pancreatitis incidence in high-risk patients.
Palavras-chave
Cholangiopancreatography, Endoscopic Retrograde, Pancreatitis
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