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Early Endoscopic Retrograde Cholangiopancreatography Versus Conservative Treatment in Patients With Acute Biliary Pancreatitis
- Source :
- Repositório Institucional da USP (Biblioteca Digital da Produção Intelectual), Universidade de São Paulo (USP), instacron:USP
- Publication Year :
- 2018
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2018.
-
Abstract
- Objectives The aim of the study was to evaluate the role of early endoscopic retrograde cholangiopancreatography (ERCP) in the treatment of acute biliary pancreatitis, in comparison with conservative treatment. Methods Systematic review via databases (MEDLINE [PubMed], Latin-American and Caribbean Health Sciences Literature database, Embase, Cochrane Central, and the [Brazilian] Regional Library of Medicine) is conducted. We analyzed 10 randomized controlled trials (1091 patients). Outcomes were the following: local and systemic adverse events; acute cholangitis; death; length of hospital stay; cost; abdominal pain; and time to a reduction in body temperature. For the meta-analysis, we used risk difference (RD) and mean with standard deviation as measures of variability. Results There was a statistically significant difference between the patients submitted to ERCP in terms of the following: local adverse events (RD, 0.74; 95% confidence interval [CI], 0.55-0.99), time to pain relief and time to a reduction in axillary temperature (RD, -5.01; 95% CI, -6.98 to -3.04, and RD, -1.70; 95 CI%, -2.33 to -1.08, respectively). Patients undergoing ERCP spent less time in hospital (RD, -11.04; 95% CI, -15.15 to -6.93). Cost was lower in the group treated with ERCP. Conclusions Early ERCP decreases local adverse events, shortening the time to pain relief, to a reduction in axillary temperature, hospital stays, and cost in patients with acute biliary pancreatitis.
- Subjects :
- medicine.medical_specialty
Abdominal pain
Biliary Tract Diseases
Endocrinology, Diabetes and Metabolism
Conservative Treatment
law.invention
03 medical and health sciences
0302 clinical medicine
Endocrinology
Randomized controlled trial
law
Internal medicine
Internal Medicine
Humans
Medicine
Adverse effect
Randomized Controlled Trials as Topic
Cholangiopancreatography, Endoscopic Retrograde
Endoscopic retrograde cholangiopancreatography
Hepatology
medicine.diagnostic_test
business.industry
Absolute risk reduction
Length of Stay
medicine.disease
Confidence interval
Pancreatitis
030220 oncology & carcinogenesis
Meta-analysis
Acute Disease
030211 gastroenterology & hepatology
medicine.symptom
business
ALIMENTAÇÃO ENTERAL
Subjects
Details
- ISSN :
- 15364828 and 08853177
- Volume :
- 47
- Database :
- OpenAIRE
- Journal :
- Pancreas
- Accession number :
- edsair.doi.dedup.....eaae097487dbb8abd719a353c3b36093