Open Access

Prophylactic ulinastatin administration for preventing post-endoscopic retrograde cholangiopancreatography pancreatitis: A meta-analysis

  • Authors:
    • Kun Zhu
    • Jian‑Ping Wang
    • Jin‑Gen Su
  • View Affiliations

  • Published online on: August 8, 2017     https://doi.org/10.3892/etm.2017.4910
  • Pages: 3036-3056
  • Copyright: © Zhu et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

The objective of the present study was to perform a meta‑analysis of all available studies on the effect of prophylactic ulinastatin administration on preventing post‑endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP). The PubMed, Web of Knowledge and Chinese National Knowledge Infrastructure databases were searched to identify all relevant studies published in English or Chinese prior to April 2016. Cochrane Review Manager was used to calculate the pooled risk ratio (RR) and 95% confidence interval (CI) to determine the effect of prophylactic ulinastatin on PEP, post‑ERCP hyperamylasemia (PEHA) and post‑ERCP abdominal pain. The analysis revealed that prophylactic ulinastatin administration significantly reduced the PEP risk (RR=0.49; 95% CI: 0.33‑0.74; P=0.0006; I2=24); however, such significant risk reduction occurred only in patients with low or average risk for PEP and high‑dosage ulinastatin (150,000 or 200,000 U) administration, and when the ulinastatin administration began prior to or during ERCP. Pre‑ERCP ulinastatin administration alone without additional administration after ERCP was sufficient. Prophylactic ulinastatin also significantly reduced the PEHA risk (RR=0.68; 95% CI: 0.56‑0.83; P=0.0001; I2=19) and marginally reduced the incidence of post‑ERCP abdominal pain (RR=0.67; 95% CI: 0.45‑1.00; P=0.05; I2=67). In conclusion, prophylactic ulinastatin administration significantly reduced the risk of PEP in patients with low or average risk for PEP when administered at a high dosage prior to or during ERCP. High‑quality studies, particularly on high-risk patients, are warranted.

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October-2017
Volume 14 Issue 4

Print ISSN: 1792-0981
Online ISSN:1792-1015

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Copy and paste a formatted citation
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Spandidos Publications style
Zhu K, Wang JP and Su JG: Prophylactic ulinastatin administration for preventing post-endoscopic retrograde cholangiopancreatography pancreatitis: A meta-analysis. Exp Ther Med 14: 3036-3056, 2017.
APA
Zhu, K., Wang , J., & Su, J. (2017). Prophylactic ulinastatin administration for preventing post-endoscopic retrograde cholangiopancreatography pancreatitis: A meta-analysis. Experimental and Therapeutic Medicine, 14, 3036-3056. https://doi.org/10.3892/etm.2017.4910
MLA
Zhu, K., Wang , J., Su, J."Prophylactic ulinastatin administration for preventing post-endoscopic retrograde cholangiopancreatography pancreatitis: A meta-analysis". Experimental and Therapeutic Medicine 14.4 (2017): 3036-3056.
Chicago
Zhu, K., Wang , J., Su, J."Prophylactic ulinastatin administration for preventing post-endoscopic retrograde cholangiopancreatography pancreatitis: A meta-analysis". Experimental and Therapeutic Medicine 14, no. 4 (2017): 3036-3056. https://doi.org/10.3892/etm.2017.4910