UpToDate
Official reprint from UpToDate®
www.uptodate.com ©2017 UpToDate, Inc. and/or its affiliates. All Rights Reserved.

Medline ® Abstract for Reference 27

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

27
TI
Incidence, severity, and mortality of post-ERCP pancreatitis: a systematic review by using randomized, controlled trials.
AU
Kochar B, Akshintala VS, Afghani E, Elmunzer BJ, Kim KJ, Lennon AM, Khashab MA, Kalloo AN, Singh VK
SO
Gastrointest Endosc. 2015 Jan;81(1):143-149.e9. Epub 2014 Aug 1.
 
BACKGROUND: Data regarding the incidence and severity of post-ERCP pancreatitis (PEP) are primarily from nonrandomized studies.
OBJECTIVE: To determine the incidence, severity, and mortality of PEP from a systematic review of the placebo or no-stent arms of randomized, controlled trials (RCTs).
DESIGN: MEDLINE, EMBASE, and Cochrane databases were searched to identify RCTs evaluating the efficacy of drugs and/or pancreatic stents to prevent PEP.
SETTING: Systematic review of patients enrolled in RCTs evaluating agents for PEP prophylaxis.
PATIENTS: Patients in the placebo or no-stent arms of the RCTs
INTERVENTION: ERCP.
MAIN OUTCOME MEASUREMENTS: Incidence, severity, and mortality of PEP.
RESULTS: There were 108 RCTs with 13,296 patients in the placebo or no-stent arms. Overall, the PEP incidence was 9.7% and the mortality rate was 0.7%. Severity of PEP was reported for 8857 patients: 5.7%, 2.6%, and 0.5% of cases were mild, moderate, and severe, respectively. The incidence of PEP in 2345 high-risk patients was 14.7% and the severity of PEP was mild, moderate, and severe in 8.6%, 3.9%, and 0.8%, respectively, with a 0.2% mortality rate. The incidence of PEP was 13% in North American RCTs compared with 8.4% in European and 9.9% in Asian RCTs. ERCPs conducted before and after 2000 had a PEP incidence of 7.7% and 10%, respectively.
LIMITATIONS: Difference in PEP risk among patients in the included RCTs.
CONCLUSION: The incidence of PEP and severe PEP is similar in high-risk patients and the overall cohort. Discrepancies in the incidence of PEP across geographic regions require further study.
AD
PMID