Rectal nonsteroidal anti-inflammatory drugs,glyceryl trinitrate,or combinations for prophylaxis of post-endoscopic retrograde cholangiopancreatography pancreatitis:A network meta-analysis

作     者：Qing-Qing Shi Guo-Xiu Huang Wei Li Jian-Rong Yang Xiao-Yi Ning 

作者机构：Department of Health Management CenterThe People’s Hospital of Guangxi Zhuang Autonomous RegionNanning 530021Guangxi Zhuang Autonomous RegionChina Department of HepatobiliaryPancreas and Spleen SurgeryThe People's Hospital of Guangxi Zhuang Autonomous RegionNanning 530021Guangxi Zhuang Autonomous RegionChina Department of HematologyThe Frist People’s Hospital of NanningNanning 530021Guangxi Zhuang Autonomous RegionChina 

出 版 物：《World Journal of Clinical Cases》 (世界临床病例杂志)

年 卷 期：2022年第10卷第22期

页      面：7859-7871页

核心收录：

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主　　题：Endoscopic retrograde cholangiopancreatography Pancreatitis Diclofenac Indomethacin Naproxen Glyceryl trinitrate 

摘      要：BACKGROUND Acute pancreatitis is the most common and severe complication of endoscopic retrograde cholangiopancreatography(ERCP).Recent evidence suggests that combinations based on rectal nonsteroidal anti-inflammatory drugs(NSAIDs)are more beneficial in preventing post-ERCP pancreatitis(PEP).Randomized controlled trials(RCTs)have also demonstrated the efficacy of glyceryl trinitrate(GTN).We conducted a network meta-analysis to compare NSAIDs and GTN for prevention of PEP and to determine whether they are better in *** To compare NSAIDs and GTN for prevention of PEP and to determine whether they are better in *** A systematic search was done for full-text RCTs of PEP in PubMed,Embase,Science Citation Index,and the Cochrane Controlled Trials *** and exclusion criteria were used to screen for eligible *** major data were extracted by two independent *** frequentist model was used to conduct this network meta-analysis and obtain the pairwise OR and 95%*** data were then extracted and assessed on the basis of the Reference Citation RESULTS Twenty-four eligible RCTs were selected,evaluating seven preventive strategies in 9416 *** indomethacin 100 mg plus sublingual GTN(OR:0.21,95%CI:0.09–0.50),rectal diclofenac 100 mg(0.34,0.18–0.65),sublingual GTN(0.34,0.12–0.97),and rectal indomethacin 100 mg(0.49,0.33–0.73)were all more efficacious than placebo in preventing *** combination of rectal indomethacin and sublingual GTN had the highest surface under the cumulative ranking curves(SUCRA)probability of(92.2%)and was the best preventive strategy for moderate-to-severe PEP with a SUCRA probability of(89.2%).CONCLUSION Combination of rectal indomethacin 100 mg with sublingual GTN offered better prevention of PEP than when used alone and could alleviate the severity of PEP.