Evidence map›Paper›PMID 35695971›Full record

SynthesisDigestive diseases and sciences2023

Combination Topical Epinephrine and Non-steroidal Inflammatory Drugs in the Prevention of Post-ERCP Pancreatitis: A Systematic Review.

Nabil El Hage Chehade, Sara Ghoneim, Sagar Shah, Anastasia Chahine, Abdulfatah Issak, Alyssa Y Choi, Zain Moosvi, Kenneth J Chang, Jason B Samarasena

Abstract readSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Digestive diseases and sciences, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 2 pooled it
0.3field-weighted citation impact, top 42% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 2 syntheses or guidelines pooled it, 3 citations in OpenAlex.

  1. Pooled it
  2. Efficacy of Topical Epinephrine in Preventing Post-Endoscopic Retrograde Cholangiopancreatography Pancreatitis: A Meta-analysis.The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology · 2024
    Pooled it
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 5 institutions in 1 country.

Nabil El Hage ChehadeDepartment of Internal Medicine, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH, USA.
Sara GhoneimDivision of Gastroenterology and Hepatology, University of Nebraska Medical Center, Omaha, NE, USA.
Sagar ShahDepartment of Internal Medicine, Ronald Reagan Medical Center, University of California Los Angeles, Los Angeles, CA, USA.
Anastasia ChahineDivision of Gastroenterology and Hepatology, H. H. Chao Comprehensive Digestive Center, University of California Irvine Medical Center, 101 The City Drive S, Orange, CA, 92868, USA.
Abdulfatah IssakDivision of Gastroenterology and Hepatology, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH, USA.
Alyssa Y ChoiDivision of Gastroenterology and Hepatology, H. H. Chao Comprehensive Digestive Center, University of California Irvine Medical Center, 101 The City Drive S, Orange, CA, 92868, USA.
Zain MoosviDivision of Gastroenterology and Hepatology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Kenneth J ChangDivision of Gastroenterology and Hepatology, H. H. Chao Comprehensive Digestive Center, University of California Irvine Medical Center, 101 The City Drive S, Orange, CA, 92868, USA.
Jason B SamarasenaDivision of Gastroenterology and Hepatology, H. H. Chao Comprehensive Digestive Center, University of California Irvine Medical Center, 101 The City Drive S, Orange, CA, 92868, USA. jason.samarasena@gmail.com.ORCID http://orcid.org/0000-0002-2981-3078
University of California, Irvine Medical Center · USMetroHealth Medical Center · USUniversity of California, Los Angeles · USUniversity of Nebraska Medical Center · USUniversity of Pittsburgh Medical Center · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe utility of combination rectal NSAID and topical epinephrine (EI) or rectal NSAID and normal saline (SI) sprayed on duodenal papilla in the prevention of post-ERCP pancreatitis (PEP) has been studied but results have been conflicting.

aimsTo evaluate the benefit of using combination prophylaxis in preventing PEP.

methodsA literature search was performed using Scopus, PubMed/MEDLINE, and Cochrane databases in May 2021. Randomized controlled trials (RCTs) involving adults patients who underwent ERCP and received EI versus SI were eligible for inclusion. The pooled effect was expressed as odds ratio (OR) to assess the rate of PEP, severity of PEP, and specific adverse events. The results were pooled using Reviewer Manager 5.4 software.

resultsSix RCTs involving 4016 patients were included in the final analysis. The EI group did not demonstrate any significant benefit over SI group in preventing PEP (OR = 1.00, 95% CI [0.68, 1.45], P = 0.98), irrespective of gender or the epinephrine concentration used. The tests for subgroup differences were not statistically significant with P-values of 0.66 and 0.28, respectively. The addition of topical epinephrine to rectal NSAID did not improve the rate of moderate to severe PEP (OR = 0.94, P = 0.86) or PEP in high-risk patients (OR = 1.14, 95%, P = 0.73). The rates of infection, including cholangitis and sepsis (OR = 0.63, P = 0.07), gastrointestinal bleeding (OR = 1.25, P = 0.56) and procedure-related death (OR = 0.71, P = 0.59) were similar between both groups.

conclusionThe addition of topical epinephrine did not demonstrate any benefit over rectal NSAID alone in preventing PEP or reducing other procedure-related adverse events.

Indexed as

Cholangiopancreatography, Endoscopic RetrogradePancreatitisAdministration, RectalAdultAnti-Inflammatory Agents, Non-SteroidalEpinephrineHumansAnti-Inflammatory Agents, Non-SteroidalEpinephrineEndoscopic retrograde cholangiopancreatographyEpinephrine sprayPost-endoscopic retrograde cholangiopancreatography pancreatitisRectal non-steroidal anti-inflammatory drugsTopical epinephrine

Identifiers

PMID35695971
OpenAlexW4282600688

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.