Indomethacin for preventing post-endoscopic retrograd cholangiopancreatography pancreatitis by rectal administration: a Meta-analysis of randomized controlled trial / 中国基层医药

ABSTRACT

Objective To assess the effectiveness and safety of indomethacin in preventing post-endoscopic retrograd cholangiopancreatography pancreatitis (PEP) by rectal administration.Methods Retrieved from PubMed,Cochrane Library,CNKI,VIP,CBM and Wanfang database,randomized blinding placebo-controlled trails about indomethacin for preventing PEP by rectal administration were included from establishment to December 2017 and comprehensively evaluated.Two reviewers independently screened literature according to the inclusion and exclusion criteria,extracted data,assessed the risk bias of included studies,and then Meta-analysis was performed using the RevMan 5.3 software.Results A total of 8 RCTs involving 3240 patients were included.The results of Meta-analysis showed that indomethacin could reduce the incidence of PEP(OR =0.57,95％ CI0.45-0.73,P ＜ 0.00 001) and moderate or severe PEP(OR =0.51,95 ％ CI0.30-0.85,P =0.010).The adverse reactions of i ndomethacin was gastrointestinal bleeding,and there was no statistically significant difference between indomethacin and placebo(OR =0.63,95％ CI0.25-1.52,P =0.300).Conclusion Indomethacin is safe and effective in reducing the incidence of PEP by rectal administration.