Original articleClinical endoscopyIncidence, severity, and mortality of post-ERCP pancreatitis: a systematic review by using randomized, controlled trials
Section snippets
Medical literature search
This systematic review was conducted by using principles outlined in Cochrane Guidelines11 and Agency for Healthcare Research and Quality Methods Guide12 and reported in accordance with the PRISMA statement.13 The PubMed, Embase, and Cochrane databases were searched by using a combination of MeSH terms, Emtree terms, and key words to identify RCTs evaluating the efficacy of drugs and pancreatic stents to prevent PEP (Appendix 1, available online at www.giejournal.org). The search had no
Search results and study characteristics
The electronic searches provided 9094 titles, of which 103 RCTs met the inclusion criteria. Five additional studies were identified by a manual search, resulting in a total of 108 studies included in the analysis (Fig. 1, Appendix 2, available online at www.giejournal.org). Translators were used to include 7 trials in Chinese, 1 in Korean, 2 in German, 1 in Hungarian, 2 in Italian, and 2 in Spanish. The dates of publication ranged from 1977 to 2012. A total of 13,296 ERCPs were in the placebo
Discussion
This present systematic review evaluated the incidence, severity, and mortality of PEP in the placebo and no-stent arms of 108 RCTs from 1977 to 2012. The overall incidence of PEP was 9.7%. The incidence of severe PEP was 0.5%, and rate of mortality caused by PEP was 0.7%. Among the non–risk-stratified and high-risk RCTs, the incidence of PEP was 8.5% and 14.7%, respectively. The incidence of severe PEP and mortality caused by PEP was similar among patients in non–risk-stratified and high-risk
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DISCLOSURE: The following authors disclosed financial relationships relevant to this article: Dr Khashab is a consultant for Olympus and Boston Scientific. Dr Kalloo is an equity holder in Apollo Endosurgery. Dr Singh is a consultant for Santarus, D-Pharm, Abbvie, and Boston Scientific. All other authors disclosed no financial relationships relevant to this article.