TY - JOUR
T1 - Prophylactic administration of somatostatin or gabexate does not prevent pancreatitis after ERCP
T2 - an updated meta-analysis
AU - Andriulli, Angelo
AU - Leandro, Gioacchino
AU - Federici, Telemaco
AU - Ippolito, Antonio
AU - Forlano, Rosario
AU - Iacobellis, Angelo
AU - Annese, Vito
PY - 2007/4
Y1 - 2007/4
N2 - Background: The prophylactic use of somatostatin or gabexate in patients undergoing ERCP is still controversial. Objective: Our purpose was to update the meta-analysis on somatostatin (SS, 16 studies) or gabexate mesylate (GM, 9 studies) prophylaxis of post-ERCP pancreatitis and to run sensitivity analyses by subgrouping trials according to schedules of drug administration. Main Outcome Measurements: Post-ERCP acute pancreatitis, hyperamylasemia, and pain. Results: Heterogeneity was present among selected studies, which appeared eliminated when only 9 high-quality trials on SS and 5 randomized studies on GM were considered. After data were pooled from SS trials, pancreatitis occurred in 7.3% of controls versus 5.3% of treated patients, a nonsignificant effect (odds ratio [OR] = 0.73; 95% CI 0.54-1.006). The funnel plot showed asymmetry with a negative slope (P = .05). The meta-analysis produced negative results for either short- (12 hours) GM administration. Conclusion: Short- or long-term infusion of SS or GM proved ineffective in reducing post-ERCP pancreatitis and pain. The beneficial effect of SS on postprocedural hyperamylasemia seems of marginal significance. When given as a bolus injection, SS maintains its promise in this field, but additional data are needed.
AB - Background: The prophylactic use of somatostatin or gabexate in patients undergoing ERCP is still controversial. Objective: Our purpose was to update the meta-analysis on somatostatin (SS, 16 studies) or gabexate mesylate (GM, 9 studies) prophylaxis of post-ERCP pancreatitis and to run sensitivity analyses by subgrouping trials according to schedules of drug administration. Main Outcome Measurements: Post-ERCP acute pancreatitis, hyperamylasemia, and pain. Results: Heterogeneity was present among selected studies, which appeared eliminated when only 9 high-quality trials on SS and 5 randomized studies on GM were considered. After data were pooled from SS trials, pancreatitis occurred in 7.3% of controls versus 5.3% of treated patients, a nonsignificant effect (odds ratio [OR] = 0.73; 95% CI 0.54-1.006). The funnel plot showed asymmetry with a negative slope (P = .05). The meta-analysis produced negative results for either short- (12 hours) GM administration. Conclusion: Short- or long-term infusion of SS or GM proved ineffective in reducing post-ERCP pancreatitis and pain. The beneficial effect of SS on postprocedural hyperamylasemia seems of marginal significance. When given as a bolus injection, SS maintains its promise in this field, but additional data are needed.
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U2 - 10.1016/j.gie.2006.10.030
DO - 10.1016/j.gie.2006.10.030
M3 - Article
C2 - 17383459
AN - SCOPUS:33947420914
VL - 65
SP - 624
EP - 632
JO - Gastrointestinal Endoscopy
JF - Gastrointestinal Endoscopy
SN - 0016-5107
IS - 4
ER -