Research article

Meta-analysis of prophylactic corticosteroid use in post-ERCP pancreatitis

Minghua Zheng^{* 1} , Jianling Bai^{* 2} , Bosi Yuan^{* 3} , Feng Lin⁴ , Jie You⁵ , Mingqin Lu¹ , Yuewen Gong⁶ and Yongping Chen¹

¹Department of Infection and Liver Diseases, The First Affiliated Hospital of Wenzhou Medical College, Wenzhou, China

²Department of Epidemiology and Biostatistics, School of Public Health Nanjing Medical University, Nanjing, China

³Department of Gastroenterology, Clinical School of Nanjing, Southern Medical University, Jinling Hospital, Nanjing, China

⁴Department of Gynecology, The First Affiliated Hospital of Wenzhou Medical College, Wenzhou, China

⁵Department of Oncology, The First Affiliated Hospital of Wenzhou Medical College, Wenzhou, China

⁶Faculty of Pharmacy, University of Manitoba, Winnipeg, Canada

author email corresponding author email* Contributed equally

BMC Gastroenterology 2008, 8:6doi:10.1186/1471-230X-8-6

Published:	14 February 2008

Abstract

Background

Acute pancreatitis is a common complication of endoscopic retrograde cholangiopancreatography and benefit of pharmacological treatment is unclear. Although prophylactic use of corticosteroid for reduction of pancreatic injury after ERCP has been evaluated, discrepancy about beneficial effect of corticosteroid on pancreatic injury still exists. The aim of current study is to evaluate effectiveness and safety of corticosteroid in prophylaxis of post-endoscopic retrograde cholangiopancreatography pancreatitis (PEP).

Methods

We employed the method recommended by the Cochrane Collaboration to perform a meta-analysis of seven randomized controlled trials (RCTs) of corticosteroid in prevention of post-ERCP pancreatitis (PEP) around the world.

Results

Most of the seven RCTs were of high quality. When the RCTs were analyzed, odds ratios (OR) for corticosteroid were 1.13 [95% CI (0.89~1.44), p = 0.32] for PEP, 1.61 [95% CI (0.74~3.52), p = 0.23] for severe PEP, 0.92 [95% CI (0.57~1.48), p = 0.73] for post-ERCP hyperamylasemia respectively. The results indicated that there were no beneficial effects of corticosteroid on acute pancreatitis and hyperamylasemia. No evidence of publication bias was found.

Conclusion

Corticosteroids cannot prevent pancreatic injury after ERCP. Therefore, their use in the prophylaxis of PEP is not recommended.