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首页> 外文期刊>Surgical Endoscopy >Does endoscopic retrograde cholangiopancreatography reduce the risk of local pancreatic complications in acute pancreatitis? A systematic review and metaanalysis.
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Does endoscopic retrograde cholangiopancreatography reduce the risk of local pancreatic complications in acute pancreatitis? A systematic review and metaanalysis.

机译：内镜逆行胰胆管造影术是否可以降低急性胰腺炎中局部胰腺并发症的风险？系统评价和荟萃分析。

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BACKGROUND: Recent studies have added to the controversy regarding the role of endoscopic retrograde cholangiopancreatography (ERCP) in the management of patients with acute biliary pancreatitis. This debate is due in part to a marked difference between the trials regarding the definition of "complication" as an outcome. This study sought to determine the effect of early ERCP versus conservative treatment on local pancreatic complications (defined by the current classification) experienced by patients with acute biliary pancreatitis. METHODS: Electronic databases (Cochrane Central Register of Controlled Trials, MEDLINE, Science Citation Index) and conference proceedings were searched for relevant randomized controlled trials up to December 2007. The effect of both treatment strategies on local pancreatic complications was calculated with random-effects models. RESULTS: Five trials involving 717 patients were included in this systematic review. Pooled analysis of all the patients with acute pancreatitisdid not demonstrate a statistically significant difference between the two treatment strategies (relative risk [RR], 0.94; 95% confidence interval [CI], 0.63-1.40; p = 0.62). Similar results were observed after subgroup analysis based on the severity of disease as follows: mild acute pancreatitis (RR, 0.79; 95% CI, 0.26-2.47; p = 0.69); severe acute pancreatitis (RR, 0.77; 95% CI, 0.30-1.98; p = 0.59). CONCLUSION: The early use of ERCP did not result in a significantly reduced risk of local pancreatic complications for either patients with mild acute pancreatitis or those with severe form of the disease.
机译：背景：最近的研究增加了关于内镜逆行胰胆管造影术（ERCP）在急性胆源性胰腺炎患者治疗中的作用的争议。这场辩论部分是由于关于“并发症”定义为结果的试验之间存在显着差异。这项研究试图确定早期ERCP与保守治疗对急性胆源性胰腺炎患者所经历的局部胰腺并发症（按当前分类定义）的影响。方法：搜索电子数据库（Cochrane对照试验中央注册，MEDLINE，《科学引文索引》）和会议记录，以寻找相关的随机对照试验，直至2007年12月。采用随机效应模型计算两种治疗策略对局部胰腺并发症的影响。 。结果：该系统评价包括五项涉及717例患者的试验。所有急性胰腺炎患者的汇总分析均未显示两种治疗策略之间的统计学差异（相对风险[RR]为0.94; 95％置信区间[CI]为0.63-1.40; p = 0.62）。根据疾病严重程度进行亚组分析后，观察到相似的结果：轻度急性胰腺炎（RR，0.79; 95％CI，0.26-2.47; p = 0.69）;重症急性胰腺炎（RR，0.77; 95％CI，0.30-1.98; p = 0.59）。结论：对于患有轻度急性胰腺炎或严重疾病的患者，早期使用ERCP不会显着降低局部胰腺并发症的风险。

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