A meta-analysis for the effect of prophylactic GTN on the incidence of post-ERCP pancreatitis and on the successful rate of cannulation of bile ducts

摘要: Glyceryl trinitrate (GTN) has been shown to be able relax the sphincter of Oddi (SO) both in animals and humans. Theoretically, use these compounds during after endoscopic retrograde cholangiopancreatgraphy (ERCP) could biliary pancreatic sphincters, facilitating cannulation common bile duct (CBD) procedure, or minimizing potential outflow obstruction procedure. However, clinical trials evaluating protective effect GTN on post-endoscopic pancreatitis (PEP) have yielded inconclusive results. This meta-analysis is systematically assess prophylactic administration glyceryl prevention PEP ducts. By searching PubMed (1966 September 2009), CENTRAL (Cochrane Controlled Register; issue 3, 2009) EMBASE.com (1984 two independent reviewers identified prospective randomized controlled (RCTs) detecting incidence A was then performed. There are 55/899(6.1%) patients suffering treatment group versus 95/915(10.4%) placebo group. The overall pooled risk significantly lower than (OR 0.56, 95% CI: 0.40 0.79, p = 0.001). Subgroup analyses suggested that administered by sublingual form 0.34,95% CI:0.16 0.75, 0.007) more effective transdermal route(OR 0.64,95% CI:0.40 1.01, 0.05), far obvious centers with high 0.40, CI:0.24 0.67, 0.0006) those a low 0.47 1.20, 0.22). Additionally, suggests not helpful for We concluded may reduce