A Meta-Analysis Of Nafamostat In The Prophylaxis Of Post-Endoscopic Retrograde Cholangiopancreatography Pancreatitis

Objective:To conduct a meta-analysis to evaluate the effectiveness of nafamostat in prophylaxising post-endoscopic retrogrde cholangiopancr-eatography pancreatitis (PEP).Methods:Cochrane Library、Embase、PubMed、VIP databases、 WANGFANG、CNKI and CBM, which were published before May 2015, were searched on the internet for randomized controlled trials (RCTs) about comparing nafamostat to placebo in prophylaxising of PEP.Two researchers collected datas from the literatures.The literature quality was independently evaluated according to the method recommended by the Cochrane Collaboration, use the software RevMan5.3 to analysis the data.Results:According to the inclusion, exclusion criterias and the retrieval strategy, a total of 4 trials involved 1494 patients were included.The Meta analysis showed that nafamostat can decrease the incidence of PEP (OR=0.34,95%CI(0.21,0.53), P<0.00001); nafamostat can not decrease the incidence of post-ERCP hyperamylasemia (PEHA) (OR=0.86, 95%CI(0.63,1.16), P=0.31); nafamostat can prophylax the incidence of PEP in high-risk and low-risk patients both (OR=0.37,95%CI(0.20,0.67), P=0.0009), (OR=0.24,95%CI(0.12,0.49), P<0.0001); nafamostat can decrease the incidence of mild-PEP and moderate-severe PEP (OR=0.38, 95%CI(0.23,0.63), P=0.0002), (OR=0.27,95%CI(0.10,0.74), P=0.01)Conclusions:Nafamostat is effective in prophylaxising PEP in high-risk and low-risk patients both, but can not decrease the incidence of PEHA, nafamostat can decrease the incidence of mild-PEP and moderate-severe PEP。...