Aggressive hydration with lactated Ringer solution prevents post-ERCP pancreatitis
The overall incidence of postendoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP), moderate to severe pancreatitis and hyperamylasaemia can be reduced by aggressive hydration with lactated Ringer solution, suggests a recent study.
In addition, aggressive hydration with lactated Ringer solution may also shorten the length of hospital stay as well as reduce pain.
Researchers performed a systematic review and meta-analysis of randomized controlled trials (RCTs) published before March 2017 to assess the clinical effectiveness and safety of aggressive hydration with lactated Ringer solution preventing PEP.
All relevant articles were accessed from PubMed, the Cochrane Library, Embase, the Web of Science, ClinicalTrial.gov and Scopus database. Reference lists from reviews or relevant articles were screened for RCTs.
The incidence of PEP and the incidence of moderate to severe pancreatitis were the primary outcomes, and the secondary outcomes were the incidence of hyperamylasaemia and pain and the length of hospitalization. The Cochrane Program Review Manager was used to perform the meta-analysis.
A total of three RCTs were included in the study. The meta-analysis revealed that patients who underwent aggressive hydration with lactated Ringer solution had a lower incidence of pancreatitis after ERCP (odds ratio [OR], 0.29; 95 percent CI, 0.16 to 0.53), moderate to severe PEP (OR, 0.16; 0.03 to 0.96) and hyperamylasaemia (OR, 0.38; 0.25 to 0.59).
Furthermore, the aggressive hydration group had a lower risk of pain (OR, 0.17; 0.08 to 0.38) and a shorter duration of hospitalization (standardized mean difference=‒0.41; ‒0.69 to ‒0.14).
“As shown in studies, aggressive hydration during the perioperative period of ERCP effectively prevents PEP,” according to researchers.