Continuous regional arterial infusion of protease inhibitors for treatment of severe acute pancreatitis: Systematic review and meta-analysis

Masayasu Horibe, Moritoki Egi, Mitsuhito Sasaki, Masamitsu Sanui

研究成果: Review article査読

10 被引用数 (Scopus)

抄録

Objective: We performed a systematic review and meta-analysis of observational studies and randomized controlled trials (RCTs) to assess the benefit and risk of continuous regional arterial infusion (CRAI) of protease inhibitors (CRAIpis) in patients with severe acute pancreatitis (SAP) or acute necrotizing pancreatitis (ANP). Methods: The search was performed using the key words "pancreatitis" and "regional arterial infusion." All language studies involving adult cases of SAP or ANP, which assessed the impact of the CRAIpis, were included. Results: Our analysis included 8 observational studies and 2 RCTs from 376 potentially relevant articles. With regard to the observational studies, the CRAIpi was significantly associated with decreased both mortality (odds ratio, 0.40; 95% confidential interval [CI], 0.25-0.64; P = 0.0001) and the need for urgent surgical intervention (odds ratio, 0.22; 95% CI, 0.12-0.3; P < 0.0001). In the RCTs, the application of CRAIpi tends to decrease the mortality but does not reach the significance (risk reduction,-0.12; 95% CI,-0.36-0.12; P = 0.33). Conclusions: The CRAIpi has the potential to reduce themortality or the need for urgent surgical intervention in cases of SAP or ANP. Further, large multicenter trials are needed to refute or confirm our findings.

本文言語English
ページ(範囲)1017-1023
ページ数7
ジャーナルPancreas
44
7
DOI
出版ステータスPublished - 2015 10 1

ASJC Scopus subject areas

  • 内科学
  • 内分泌学、糖尿病および代謝内科学
  • 肝臓学
  • 内分泌学

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