Prophylactic value of aggressive hydration with lactated Ringer′s solution during the perioperative period for post-ERCP pancreatitis: a meta-analysis

Abstract

Objective To evaluate aggressive hydration with lactated Ringer′s solution for prophylaxis of post-ERCP pancreatitis(PEP) during the perioperative period. Methods CNKI, VIP, Wangfang, Pubmed, Embase and Cochrane Library were searched for randomized controlled trials(RCTs)on aggressive hydration with lactated Ringer′s solution for preventing PEP published from the setup time of databases to June 2018. According to the inclusion and exclusion criteria, RCTs were selected by two researchers, data were extracted and methodological quality was assessed independently. Revman 5.3 was used to perform the meta-analysis.The heterogeneity among the included RCTs was analyzed by using the Q test and the chi-square test. The funnel plots, the risk of bias graph and the risk of bias summary were used to evaluate publication bias. Results A total of 10 RCTs with 1 727 patients were included.Meta-analysis showed that 10 RCTs had no significant heterogeneity (P=0.10, I2=39%), aggressive hydration with lactated Ringer′s solution could reduce the incidence of PEP(OR=0.37, 95%CI: 0.26-0.53, P<0.000 01). Hyperamylasemia incidence was included in 6 RCTs, and the results showed that aggressive hydration with lactated Ringer′s solution could reduce the incidence of hyperamylasemia (OR=0.41, 95%CI: 0.27-0.64, P<0.000 01). A total of 4 RCTs compared the incidence of abdominal pain after ERCP between the experimental group and the control group. Meta-analysis showed that aggressive hydration with lactated Ringer′s solution could reduce the incidence of abdominal pain (OR=0.32, 95%CI: 0.15-0.68, P=0.003). Conclusion Aggressive hydration with lactated Ringer′s solution can effectively prevent PEP and other complications. Key words: Pancreatitis; Lactated Ringer′s solution; Aggressive hydration; Meta-analysis