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Medline ® Abstract for Reference 130

of 'Post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis'

Meta-analysis of prophylactic allopurinol use in post-endoscopic retrograde cholangiopancreatography pancreatitis.
Zheng M, Chen Y, Bai J, Xin Y, Pan X, Zhao L
Pancreas. 2008;37(3):247.
UNLABELLED: The aim of this study was to evaluate the effectiveness and the safety of allopurinol in the prophylaxis of post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis.
METHODS: : We used the method recommended by the Cochrane Collaboration to perform a meta-analysis of randomized controlled trials (RCTs) of allopurinol in the prevention of post-ERCP pancreatitis (PEP), including 6 RCTs conducted all over the world.
RESULTS: : Six RCTs totaling 1554 patients undergoing ERCP were included. When the RCTs were analyzed, odds ratios of allopurinol were 0.74 (95% confidence interval [CI], 0.37-1.48; P = 0.40) for PEP, 0.87 (95% CI, 0.33-2.28; P = 0.78) for severe PEP, 0.88 (95% CI, 0.37-2.11; P = 0.78) for post-ERCP hyperamylasemia, and 0.19 (95% CI, 0.01-3.91; P = 0.28) for case-fatality ratio of PEP, thus indicating no beneficial effects of allopurinol on acute pancreatitis, PEP death rate, and hyperamylasemia. No evidence of publication bias was found.
CONCLUSIONS: : Allopurinol cannot prevent the pancreatic injury after ERCP. Allopurinol is not recommended in the prophylaxis of PEP.
Department of Infection and Liver Diseases, The First Affiliated Hospital of Wenzhou Medical College, Wenzhou, China.