Objective To systematically evaluate the clinical efficacy of somatostatin and its analogues combined with proton pump inhibitor in the prevention of pancreatitis after endoscopic retrograde cholangiopancreatography( ERCP) by an evidence-based medicine approach.Methods Articles were searched manually or by computer,and were enrolled using methods recommended by the Cochrane Reviewer' s Handbook. The meta-analysis was performed using Rev Man 5. 2 software. Results Five randomized controlled trials were finally enrolled,which involved 1092 patients,including 538 patients in the control group and 554 patients in the experimental group. According to the results of the meta-analysis,patients who received somatostatin and its analogues combined with proton pump inhibitor had lower short-term and long-term serum amylase levels after surgery than patients in the control group( MD =-198. 44,95% CI:-305. 83 ~-91. 05;MD =-103. 48,95% CI:-157. 53 ~-49. 42). Patients who received somatostatin and its analogues combined with proton pump inhibitor also had lower incidence rates of hyperamylasemia and pancreatitis after ERCP than patients in the control group( OR = 0. 29,95% CI: 0. 17 ~0. 51; OR = 0. 24,95% CI: 0. 13 ~ 0. 46). Conclusion Somatostatin and its analogues combined with proton pump inhibitor are effective in reduction of the serum amylase level and prevention of the incidence of pancreatitis after ERCP.
DownLoad: