Prophylactic Value Of Aggressive Hydration With Lactated Ringer’s Solution During The Perioperative Period For Post-ERCP Pancreatitis:A Meta-Analysis

Objective:To evaluate aggressive hydration with lactated Ringer’s solution for prophylaxis of post-ERCP pancreatitis(PEP)during the perioperative period.Methods:CNKI,VIP,Wangfang,Pubmed,Embase and Cochrane Library were searched for randomized controlled trials(RCTs)on aggressive hydration with lactated Ringer’s solution for preventing post-ERCP pancreatitis published from the setup time of database to June2018.According to the inclusion and exclusion criteria,RCTs were selected by two researchers,data was extracted and methodological quality was assessedindependently.Revman5.3wasusedtoperformthe meta-analysis.The heterogeneity among the included RCTs was analyzed by using the Q test and the chi-square test.The funnel plots,the risk of bias graph and the risk of bias summary were used to evaluate publication bias.Results:Atotalof10RCTswith1727patientswere included.Meta-analysis showed that 10 RCTs had no significant heterogeneity(P=0.10,I~2=39%),aggressive hydration with lactated Ringer’s solution could reduce the incidence of PEP(OR=0.37,95%CI:0.26-0.53,P<0.00001).Hyperamylasemia incidence was included in 6RCTs,and the results showed that aggressive hydration with lactated Ringer’s solution could reduce the incidence of hyperamylasemia(OR=0.41,95%CI:0.27-0.64,P<0.00001),A total of 4 RCTs compared the incidence of abdominal pain after ERCP between the experimental group and the control group.Meta-analysis showed that aggressive hydration with lactated Ringer’s solution could reduce the incidence of abdominal pain(OR=0.32,95%CI:0.15-0.68,P=0.003).Conclusion:Aggressive hydration with lactated Ringer’s solution can effectively prevent post-ERCP pancreatitis and other comlications.