| Objective: Acute pancreatitis (AP) is a very common disease of the pancreas, and also one of the acute abdominal disease in the digestive system, compared 22.4% percent of the pancreatic disease. Of all the AP, acute biliary pancreatitis (ABP) is the most common one ,which compared more than 50% ,and 80% in the severe acute pancreatitis (SAP), the fatality rate of which is 20%~35%. Therefore, the therapy of ABP has a significant meaning in the outcome and prognosis of AP. After 1980s, endoscopy is gradually applied to ABP ,but the curative effect and efficacy is still controversial. We did this meta-analysis to assess the efficacy and security of ERCP in the management of ABP.Methods: Pubmed, Cochrane library, CNKI, CBM and WeiPu database were searched from the beginning to July 2008, and the references of eligible studies were also screened. Randomized controlled trials comparing acute biliary pancreatitis with conservative treatment were eligible for inclusion. Two investigators independently assessed the quality and extracted the data. Heterogeneity was examined by Chi-square test. Fixed effect model was used to pool the data. Results: sixteen RCTs were included (n=2115). Only three of them listed the method of randomization and others did not report in details. The two groups of each trial were comparable and two trials showed P>0.05. The analysis was done by RevMan 4.2.2. It was found that, compared with the controlled group, ERCP group could decrease plasma amylase [OR=-2.84, 95%CI(-3.39, -2.29)], mortality [OR=-3.74, 95%CI(-4.28, -3.20)], the rate of operation[OR=0.11, 95%CI(0.05, 0.21)] and complication [OR=0.38, 95%CI(029, 0.49)], also abdominal pain disappeared more quickly [OR=-3.74, 95%CI(-4.28, -3.20)](P<0.05).Conclusions: Compared with conservative treatment in acute biliary pancreatitis, ERCP could decrease plasma amylase, the rate of mortality, operation, and complication more quickly. Abdominal pain recovered more quickly too.
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