Post-endoscopic retrograde cholangiopancreatography pancreatitis: A systematic review for prevention and treatment

Table 3 Brief contents of reviewed articles on pharmacological agents

Agent	Authors	Year	Country	n	Design	Incidence of PEP1			P value
						Study group		Control (or compared)
Intraduodenal Acetic Acid (IAA)	Fang et al[97]	2018	China	210	Prospective, single center, double-blind	8/105 (7.6%) [IAA]		11 /105 (10.5%) [Saline]	0.47
Celecoxib	Kato et al[77]	2017	Japan	170	Prospective, single center	10/85 (11.7%) [Celecoxib]		13/85 (15.3%) [Saline]	0.65
Raw Rhubarb Solution (RRS)	Wang et al[133]	2017	China	500	Prospective, single center	5/250 (2%) [RRS]		19/250 (7.6%) [Water]	0.003
Nitroglycerin + Glucagon	Katsinelos et al[106]	2017	Greece	455	Prospective, single center, double–blind	7/227 (3.08%) [Nitroglycerin + glucagon]		17/228 (7.46%) [HBW]	0.037
Ketoprofen	Onofrio et al[73]	2017	Brazil	477	Prospective, single center, double-blind, placebo-controlled	5/224 (2.2 %) [Ketoprofen]		5/253 (2 %) [Placebo]	1.0
Vigorous IVFR	Choi et al[87]	2017	South Korea	510	Prospective, multi center, double-blind	11/255 (4.3%) [Vigorous IVFR]		25/255 (9.8%) [StandartIVFR]	0.016
Aggressive Hydration with Lactated Ringer’s Solution (AHLRS)	Buxbaum et al[83]	2014	United States	71	Prospective, multicenter, controlled	0/39 (0%) [AHLRS]		4/23 (17%) [SHLRS]	0.016
Udenafil+Aceclofenac	Lee et al[109]	2015	South Korea	216	Prospective, multicenter, double-blind, placebo-controlled	17/107 (15.8%) [Udenafil+Aceclofenac]		18/109 (16.5%) [Placebo]	0.901
Somatostatin	Bai et al[127]	2015	China	900	Prospective, multicenter, open-label	18/445 (4 %) [Somatostatin]		34/455 (7.5 %) [No Somatostatin]	0.03
	Concepcion-Martin et al[129]	2014	Spain	510	Prospective, single-center, placebo-controlled, double-blind	19/255 (7.5 %) [Somatostatin]		17/255 (6.7 %) [Placebo]	0.73
	Wang et al[130]	2013	China	124	Prospective, single-center, placebo-controlled	6/36 (16.7%) [Pre-ERCP somatostatin]	5/47 (10.6%) [Post-ERCP somatostatin]	6/41 (14.6%) [Placebo]	0.715
Intramuscular Diclofenac	Park et al[66]	2015	South Korea	343	Prospective, single center, double-blind, placebo-controlled	22/173 (12.7 %) [Intramuscular Diclofenac]		20/170 (11.8 %) [Placebo]	0.87
Rectal Diclofenac	Otsuka et al[68]	2012	Japan	104	Prospective, multicenter, controlled	2/51 (3.9%) [Diclofenac with Saline]		10/53 (18.9%) [Saline]	0.017
Nafamostat Mesilate (NM)	Kim et al[118]	2016	South Korea	382	Prospective, single center, comparative	5/179 (2.8%) [NM - 24 hour infusion]		4/192 (2.1%) [NM - 6 hour infusion]	0.744
	Ohuchida et al[114]	2015	Japan	809	Prospective, single center, double-blind	14/405 (3.5) [NM]		27/404 (6.7) [Glucose Solution]	0.035
	Park et al[115]	2011	South Korea	595	Prospective, single-center, controlled	8/198 (4%) [20 mg of NM]	10/197 (5.1%) [50 mg of NM]	26/200 (13%) [Dextrose]	< 0.0001
	Yoo et al[117]	2011	South Korea	286	Prospective, single-center, double-blind, placebo controlled	4/143 (2.8%) [NM]		13/143 (9.1%) [Dextrose Solution]	0.03
	Choi et al[116]	2009	South Korea	704	Prospective, single-center, double-blind, controlled	12/354 (3.3%) [NM]		26/350 (7.4%) [Dextrose Solution]	0.018
Ulinastatin + Nafamostat	Park et al[121]	2014	South Korea	159	Prospective, single center, placebo-controlled	1/53 (1.9%) [Ulinastatin]	2/53 (3.8%) [Nafamotat]	7/53 (13.2) [Placebo]	0.037
Risperidone + Ulinastatin	Tsujino et al[125]	2013	Japan	226	Prospective, multicenter, placebo-controlled	6/113 (5.3%) [Risperidone + Ulinastatin]		10/113 (8.8 %,) [Ulinastatin]	0.438
Udenafil	Oh et al[107]	2011	South Korea	278	Prospective, multicenter, double-blind, placebo-controlled	11/137 (8.0%) [Udenafil]		11/141 (7.8%) [Placebo]	944
Allopurinol	Abbasinazari et al[135]	2011	Iran	74	Prospective, single-center, double-blind, placebo-controlled	3/29 (10,4%) [Allopurinol]		5/45 (11,1%) [Placebo]	0.97
Neurokinin-1 receptor antagonist (Aprepitant)	Shah et al[136]	2012	United States	73	Prospective, single-center, double-blind, placebo-controlled	7/34 (20.6%) [Aprepitant]		7/39 (17.9%) [Placebo]	1.0
Secretin	Jowell et al[96]	2011	United States	869	Prospective, single-center, double-blind, placebo controlled	36/413 (8.7%) [Secretin]		65/431 (15.1%) [Placebo]	0.004
Epinephrine	Xu et al[143]	2011	China	941	Prospective, single-center, placebo controlled	9/461 (1.95%) [Epinephrine]		31/480 (6.45%) [Saline]	0.0086
Valdecoxib and GlycerylTrinitrate (GTN)	Bhatia et al[70]	2011	India	371	Prospective, single-center, controlled	12/121 (9.9%) [Valdecoxib]	12/124 (9.7%) [GTN]	13/126 (10.3%) [No intervention]	0.986
Glyceryl Nitrate	Nøjgaard et al[100]	2009	Multi Country	806	Prospective, multicenter, double-blind, placebo-controlled	18/401 (4.5%) [Glyceryl Nitrate]		29/405 (7.1%) [Placebo]	0.11
Platelet Activating Factor (PAF)	Sherman et al[91]	2009	United States	600	Prospective, multicenter, double-blind, placebo-controlled	35/200 (17.5%) [PAF 1 mg/kg]	32/201 (15.9%) [PAF 5 mg/kg]	39/199 (19.6%) [Placebo]	0.59
Interleukin-10 (IL-10)	Sherman et al[88]	2009	Multi Country	305	Prospective, multicenter, double-blind, placebo-controlled	14/91 (15.4%) [IL-10 8 µg/kg]	24/109 (22%) [IL-10 20 µg/kg]	15/105 (14.3%) [Placebo]	0.83 0.14

¹The fractional ratios are “Number of PEP incidences/number of patients in the group”. Rate of PEP incidences are given in the parenthesis. Definitions of the procedures applied to groups are given in the brackets. HBW: Hyoscine n-butyl plus sterile water; IVFR: Intravenous fluid resuscitation; SHLRS: Standart hydration with lactated ringer’s solution.