Journal article
Post-Endoscopic Retrograde Cholangiopancreatography Pancreatitis Prophylaxis: Does the Choice of Crystalloid Fluid Matter? A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Pancreas, Vol.55(2), pp.e157-e161
02/2026
DOI: 10.1097/MPA.0000000000002611
PMID: 41396284
Abstract
The optimal crystalloid choice for post-ERCP pancreatitis (PEP) prophylaxis is not clear. To evaluate the published literature further, we conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) comparing intravenous (IV) hydration with lactated Ringer's (LR) and normal saline (NS) for PEP prevention.
A random-effects model was used. The primary outcome was risk of PEP. Effect estimates were expressed as risk difference (RD) and 95% confidence interval (CI).
Pooling analysis of published RCTs with 594 patients (41.1% males, mean age 57.6) showed statistically significant risk reduction of PEP in the LR group compared to the NS group (RD -0.04; 95% CI [-0.08, -0.00], P=0.03, I2=0) There was no significant risk difference in other adverse events.
At equivalent fluid administration rates, using LR compared to NS showed a significant risk reduction in PEP of 4% with a number needed to treat (NNT) of 25. LR may be the better crystalloid for ERCP. Further studies are needed to validate these results.
Details
- Title: Subtitle
- Post-Endoscopic Retrograde Cholangiopancreatography Pancreatitis Prophylaxis: Does the Choice of Crystalloid Fluid Matter? A Systematic Review and Meta-Analysis of Randomized Controlled Trials
- Creators
- Tareq Alsaleh - AdventHealth OrlandoSaurabh Chandan - AdventHealth OrlandoAbdul Mohammed - AdventHealth OrlandoNihal Khan - AdventHealth OrlandoMohamad Khaled Almujarkesh - AdventHealth OrlandoAbdullah Abbasi - AdventHealth OrlandoSagar Pathak - AdventHealth OrlandoMaham Hayat - AdventHealth OrlandoDeepanshu Jain - AdventHealth OrlandoNatalie Cosgrove - AdventHealth OrlandoKambiz Kadkhodayan - AdventHealth OrlandoDennis Yang - AdventHealth OrlandoMuhammad Hasan - AdventHealth OrlandoJohn George - AdventHealth OrlandoMustafa Arain - AdventHealth Orlando
- Resource Type
- Journal article
- Publication Details
- Pancreas, Vol.55(2), pp.e157-e161
- DOI
- 10.1097/MPA.0000000000002611
- PMID
- 41396284
- NLM abbreviation
- Pancreas
- ISSN
- 1536-4828
- eISSN
- 1536-4828
- Publisher
- Wolters Kluwer
- Language
- English
- Electronic publication date
- 12/15/2025
- Date published
- 02/2026
- Academic Unit
- Internal Medicine
- Record Identifier
- 9985091815702771
Metrics
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