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Title: Pancreatic Stent Placement for Prevention of Post-ERCP Pancreatitis in High-Risk Patients: A Systematic Review and Meta-Analysis
Authors: PORTELA, Joaquim Coelho da CruzBERNARDO, Wanderley MarquesMOURA, Diogo Turiani Hourneaux deFRANZINI, Tomazo Antonio PrinceCOUTINHO, Lara Meireles de AzeredoBRUNALDI, Vitor OttoboniGUEDES, Hugo GoncaloMOURA, Eduardo Turiani Hourneaux deSANTOS, Marcos Eduardo Lera dosLUZ, Gustavo OliveiraMOURA, Eduardo Guimaraes Hourneaux de
Citation: JOURNAL OF THE PANCREAS, v.20, n.1, p.16-23, 2019
Abstract: 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.
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LIM/26 - Laboratório de Pesquisa em Cirurgia Experimental

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LIM/35 - Laboratório de Nutrição e Cirurgia Metabólica do Aparelho Digestivo

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