Background and aims

Previous studies have suggested that aggressive hydration with lactated ringer solution are one of the protective factors in preventing post endoscopic retrograde cholangiopancreatography (post-ERCP). We conducted a systematic review and meta-analysis to examine the efficacy aggressive hydration with lactated Ringer solution in preventing PEP.

Methods

All published and unpublished articles on aggressive hydration with lactated ringer solution in those underwent ERCP procedure for any reasons were screened for eligibility. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. This paper doesn’t need the IRB approval.

Results

Seven RCTs met the inclusion criteria. Meta-analysis indicates that aggressive hydration with lactated Ringer solution were associated with lower PEP rate.[odds ratio (OR) 0.29; 95% confidence interval (CI) 0.18–0.48]; lower incidence of hyperamylasemia (OR 0.49; 95% CI 0.35, 0.69) and lower risk of pain (OR 0.28; 95% CI 0.10–0.81). The association between aggressive hydration with lactated Ringer solution and incidence of moderate severity PEP were unclear (OR 0.57; 95% CI 0.22, 1.45). Sensitivity analyses also showed that omitting 1 study from analysis of PEP rate could reduce the heterogeneity but did not change the conclusion of this meta-analysis. A cumulating meta-analysis was performed statistically which showed a stable result of overall incidence of PEP.

Conclusions

Aggressive hydration with lactated Ringer solution was a protective factor in reducing the overall incidence of PEP, hyperamylasemia and risk of abdominal pain.

中文翻译：

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与预防性内镜逆行胰胆管造影术后胰腺炎相比，积极的水合与乳酸林格氏液标准水合比较

背景和目标

先前的研究表明，用乳酸林格液积极水合是预防内镜后逆行胰胆管造影（ERCP后）的保护因素之一。我们进行了系统的综述和荟萃分析，以研究乳酸林格液积极水合预防PEP的功效。

方法

筛选因任何原因接受ERCP程序的那些使用乳酸林格液积极水合的已发表和未发表的文章。遵循了系统评价和荟萃分析的首选报告项目指南。本文不需要IRB批准。

结果

七个RCT符合纳入标准。荟萃分析表明，乳酸林格液的积极水合作用与较低的PEP率相关。[比值比（OR）为0.29；95％置信区间（CI）0.18–0.48]；高淀粉血症的发生率较低（OR 0.49； 95％CI 0.35，0.69），疼痛风险较低（OR 0.28； 95％CI 0.10-0.81）。乳酸林格液的积极水合与中度严重性PEP的发生之间的关联尚不清楚（OR 0.57； 95％CI 0.22，1.45）。敏感性分析还表明，从PEP率分析中省略1项研究可以减少异质性，但不会改变该荟萃分析的结论。统计地进行累积荟萃分析，显示出PEP总体发生率稳定。

结论

乳酸林格液的积极水合作用是降低PEP总体发生率，高淀粉血症和腹痛风险的保护因素。