Pre-emptive hydration with lactated Ringer's solution could reduce the incidence of post-endoscopic retrograde cholangiopancreatography pancreatitis in at-risk patients: Propensity score-matched analysis.

Abstract

This study aimed to investigate the efficacy of intensive fluid-loading therapy post-endoscopic retrograde cholangiopancreatography (ERCP) for the prevention of post-ERCP pancreatitis (PEP) in at-risk patients. In this retrospective study, data of 1200 patients at risk for PEP were investigated. After propensity score matching, 404 patients were included in the normal (n=202) and hydration (n=202) groups. On the day of ERCP, patients in both groups were infused with 2000 ml/24 h of fluid before ERCP. Meanwhile, the hydration group received an additional 1000 ml/10h of lactated Ringer's solution postoperatively. The incidence of PEP was lower in the hydration group (12.4%) than in the normal group (24.3%) (odds ratio [OR]: 0.44; 95% CI: 0.26-0.75, p=.003). The incidence of severe PEP was 2.0% and 6.9% in the hydration and normal groups (OR: 0.27; 95% CI: 0.09-0.84, p=.027), respectively. The incidence of fatal PEP was 0% and 2.0% in the hydration and normal groups (OR: N.A.: p=.123), respectively. Post-ERCP hydration may be an effective method of preventing PEP, including severe PEP, in at-risk patients.