Post-Endoscopic Retrograde Cholangiopancreatography Pancreatitis Prophylaxis: Does the Choice of Crystalloid Fluid Matter? A Systematic Review and Meta-analysis of Randomized Controlled Trials.

IF 2.2 4区医学 Q3 GASTROENTEROLOGY & HEPATOLOGY

Pancreas Pub Date : 2026-02-01 DOI:10.1097/MPA.0000000000002611

Tareq Alsaleh, Saurabh Chandan, Abdul Mohammed, Nihal Khan, Mohamad Khaled Almujarkesh, Abdullah Abbasi, Sagar Pathak, Maham Hayat, Deepanshu Jain, Natalie Cosgrove, Kambiz Kadkhodayan, Dennis Yang, Muhammad Hasan, John George, Mustafa Arain

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引用次数: 0

Abstract

Objectives: The optimal crystalloid choice for post-ERCP pancreatitis (PEP) prophylaxis is not clear. To evaluate the published literature further, we conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) comparing intravenous (IV) hydration with lactated Ringer (LR) and normal saline (NS) for PEP prevention.

Materials and methods: A random-effects model was used. The primary outcome was the risk of PEP. Effect estimates were expressed as risk difference (RD) and 95% CI.

Results: Pooling analysis of published RCTs with 594 patients (41.1% males, mean age: 57.6) showed statistically significant risk reduction of PEP in the LR group compared with the NS group [RD: -0.04; 95% CI (-0.08, -0.00), P = 0.03, I 2 = 0]. There was no significant risk difference in other adverse events.

Conclusion: At equivalent fluid administration rates, using LR compared with NS showed a significant risk reduction in PEP of 4% with a number needed to treat (NNT) of 25. LR may be the better crystalloid for ERCP. Further studies are needed to validate these results.

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内镜逆行胰胆管造影后胰腺炎预防：晶体液体的选择重要吗？随机对照试验的系统评价和荟萃分析。

目的：ercp后胰腺炎（PEP）预防的最佳晶体选择尚不清楚。为了进一步评估已发表的文献，我们对随机对照试验（rct）进行了系统回顾和荟萃分析，比较静脉（IV）水合与乳酸林格氏液（LR）和生理盐水（NS）预防PEP的效果。方法：采用随机效应模型。主要观察指标为PEP风险。效果估计用风险差（RD）和95%置信区间（CI）表示。结果：对已发表的594例患者（41.1%为男性，平均年龄57.6岁）的rct进行池化分析，结果显示，与NS组相比，LR组PEP风险降低具有统计学意义（RD -0.04; 95% CI [-0.08, -0.00]， P=0.03, I2=0），其他不良事件风险差异无统计学意义。结论：在相同的液体给药率下，与NS相比，使用LR可显着降低PEP的风险4%，所需治疗数（NNT）为25。对于ERCP， LR可能是更好的晶体。需要进一步的研究来验证这些结果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pancreas 医学-胃肠肝病学

CiteScore

4.70

自引率

3.40%

发文量

289

审稿时长

1 months

期刊介绍： Pancreas provides a central forum for communication of original works involving both basic and clinical research on the exocrine and endocrine pancreas and their interrelationships and consequences in disease states. This multidisciplinary, international journal covers the whole spectrum of basic sciences, etiology, prevention, pathophysiology, diagnosis, and surgical and medical management of pancreatic diseases, including cancer.