Use of NSAIDs via the Rectal Route for the Prevention of Pancreatitis after ERCP in All-Risk Patients: An Updated Meta-Analysis
The aim of this study was to assess the efficacy of the rectal administration of nonsteroidal anti-inflammatory drugs (NSAIDs) in preventing post-ERCP pancreatitis (PEP). We searched database for randomized controlled trials (RCTs) comparing periprocedural rectal administration of NSAIDs with placeb...
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| Format: | Article |
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Wiley
2018-01-01
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| Series: | Gastroenterology Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2018/1027530 |
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| author | Lei-Min Yu Ke-Jia Zhao Bin Lu |
| author_facet | Lei-Min Yu Ke-Jia Zhao Bin Lu |
| author_sort | Lei-Min Yu |
| collection | DOAJ |
| description | The aim of this study was to assess the efficacy of the rectal administration of nonsteroidal anti-inflammatory drugs (NSAIDs) in preventing post-ERCP pancreatitis (PEP). We searched database for randomized controlled trials (RCTs) comparing periprocedural rectal administration of NSAIDs with placebo for the prevention of PEP. The rectal administration of NSAIDs significantly decreased the incidence of PEP in the whole patient population (odds ratio (OR): 0.44, 95% confidence interval (CI): 0.30–0.64, P<0.0001), high-risk patients (OR: 0.34, 95% CI: 0.19–0.58, P=0.0001), and all-risk patients (OR: 0.51, 95% CI: 0.31–0.84, P=0.008). The incidence of PEP was reduced by indomethacin (OR: 0.54, 95% CI: 0.36–0.82, P=0.004) and diclofenac (OR: 0.27, 95% CI: 0.15–0.46, P<0.00001). The administration of NSAIDs before (OR: 0.42, 95% CI: 0.25–0.73, P=0.002) or after (OR: 0.39, 95% CI: 0.27–0.56, P<0.00001) ERCP reduced PEP. The NSAIDs were associated with a reduction in mild PEP (OR: 0.55, 95% CI: 0.36–0.83, P=0.004) and moderate-to-severe PEP (OR: 0.47, 95% CI: 0.28–0.79, P=0.004). The rectal administration of NSAIDs reduced the incidence of PEP in high-risk and all-risk patients. |
| format | Article |
| id | doaj-art-0d7afb2d496545f79d9b3256d310f813 |
| institution | Kabale University |
| issn | 1687-6121 1687-630X |
| language | English |
| publishDate | 2018-01-01 |
| publisher | Wiley |
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| series | Gastroenterology Research and Practice |
| spelling | doaj-art-0d7afb2d496545f79d9b3256d310f8132025-02-03T01:02:19ZengWileyGastroenterology Research and Practice1687-61211687-630X2018-01-01201810.1155/2018/10275301027530Use of NSAIDs via the Rectal Route for the Prevention of Pancreatitis after ERCP in All-Risk Patients: An Updated Meta-AnalysisLei-Min Yu0Ke-Jia Zhao1Bin Lu2Department of Gastroenterology, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, ChinaDepartment of Gastroenterology, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, ChinaDepartment of Gastroenterology, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, ChinaThe aim of this study was to assess the efficacy of the rectal administration of nonsteroidal anti-inflammatory drugs (NSAIDs) in preventing post-ERCP pancreatitis (PEP). We searched database for randomized controlled trials (RCTs) comparing periprocedural rectal administration of NSAIDs with placebo for the prevention of PEP. The rectal administration of NSAIDs significantly decreased the incidence of PEP in the whole patient population (odds ratio (OR): 0.44, 95% confidence interval (CI): 0.30–0.64, P<0.0001), high-risk patients (OR: 0.34, 95% CI: 0.19–0.58, P=0.0001), and all-risk patients (OR: 0.51, 95% CI: 0.31–0.84, P=0.008). The incidence of PEP was reduced by indomethacin (OR: 0.54, 95% CI: 0.36–0.82, P=0.004) and diclofenac (OR: 0.27, 95% CI: 0.15–0.46, P<0.00001). The administration of NSAIDs before (OR: 0.42, 95% CI: 0.25–0.73, P=0.002) or after (OR: 0.39, 95% CI: 0.27–0.56, P<0.00001) ERCP reduced PEP. The NSAIDs were associated with a reduction in mild PEP (OR: 0.55, 95% CI: 0.36–0.83, P=0.004) and moderate-to-severe PEP (OR: 0.47, 95% CI: 0.28–0.79, P=0.004). The rectal administration of NSAIDs reduced the incidence of PEP in high-risk and all-risk patients.http://dx.doi.org/10.1155/2018/1027530 |
| spellingShingle | Lei-Min Yu Ke-Jia Zhao Bin Lu Use of NSAIDs via the Rectal Route for the Prevention of Pancreatitis after ERCP in All-Risk Patients: An Updated Meta-Analysis Gastroenterology Research and Practice |
| title | Use of NSAIDs via the Rectal Route for the Prevention of Pancreatitis after ERCP in All-Risk Patients: An Updated Meta-Analysis |
| title_full | Use of NSAIDs via the Rectal Route for the Prevention of Pancreatitis after ERCP in All-Risk Patients: An Updated Meta-Analysis |
| title_fullStr | Use of NSAIDs via the Rectal Route for the Prevention of Pancreatitis after ERCP in All-Risk Patients: An Updated Meta-Analysis |
| title_full_unstemmed | Use of NSAIDs via the Rectal Route for the Prevention of Pancreatitis after ERCP in All-Risk Patients: An Updated Meta-Analysis |
| title_short | Use of NSAIDs via the Rectal Route for the Prevention of Pancreatitis after ERCP in All-Risk Patients: An Updated Meta-Analysis |
| title_sort | use of nsaids via the rectal route for the prevention of pancreatitis after ercp in all risk patients an updated meta analysis |
| url | http://dx.doi.org/10.1155/2018/1027530 |
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