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Nitroglycerin in the Prevention of Post-ERCP Pancreatitis: A Meta-Analysis

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Abstract

The objective of this research paper is to evaluate the effect of prophylactic nitroglycerin in the prevention of post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) by performing a meta-analysis of randomized controlled trials (RCTs). Electronic databases, including PubMed, EMBASE, the Cochrane library, and the Science Citation Index, were searched to retrieve relevant trials. Outcome measures were the incidence of PEP. Four RCTs, enrolling a total of 856 patients, were included. Meta-analysis of these trials indicated a significant association between the use of nitroglycerin and the reduction of PEP (RR 0.60; 95%CI: 0.39–0.92; P = 0.02). However, subsequent sensitive analysis failed to confirm that nitroglycerin was statistically superior to a placebo in reducing PEP (RR 0.68; 95%CI: 0.41–1.11; P = 0.12). Based on the limitations in this meta-analysis, prophylactic use of nitroglycerine for all patients who underwent ERCP is not recommended. Further clinical trials are required to confirm the effect of nitroglycerin in the prevention of PEP.

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Acknowledgments

We are indebted to the authors of the primary studies.

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Authors and Affiliations

  1. Department of Gastroenterology, Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, 310009, China

    Li-Ming Shao, Qing-Yu Chen, Miao-Yan Chen & Jian-Ting Cai

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  1. Li-Ming Shao
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Correspondence to Jian-Ting Cai.

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Li-Ming Shao and Qing-Yu Chen contributed equally to this work.

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Shao, LM., Chen, QY., Chen, MY. et al. Nitroglycerin in the Prevention of Post-ERCP Pancreatitis: A Meta-Analysis. Dig Dis Sci 55, 1–7 (2010). https://doi.org/10.1007/s10620-008-0709-9

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