Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2007 Feb 12:7:6.
doi: 10.1186/1471-230X-7-6.

Gabexate in the prophylaxis of post-ERCP pancreatitis: a meta-analysis of randomized controlled trials

Minghua Zheng  1 , Yongping Chen, Xinjun Yang, Ji Li, Youcai Zhang, Qiqiang Zeng
Affiliations
Meta-Analysis

Gabexate in the prophylaxis of post-ERCP pancreatitis: a meta-analysis of randomized controlled trials

Minghua Zheng et al. BMC Gastroenterol. .

Abstract

Background: Acute pancreatitis is a common complication of endoscopic retrograde cholangiopancreatography and the benefit of its pharmacological treatment is unclear. Although prophylactic use of gabexate for the reduction of pancreatic injury after ERCP has been evaluated, the discrepancy about gabexate's beneficial effect on pancreatic injury still exists. This study aimed to evaluate the effectiveness and safety of gabexate in the prophylaxis of post-endoscopic retrograde cholangiopancreatography pancreatitis (PEP).

Methods: We employed the method recommended by the Cochrane Collaboration to perform a meta-analysis of randomized controlled trials (RCTs) of gabexate in the prevention of post-ERCP pancreatitis (PEP) including three RCTs conducted in Italy and one in China.

Results: All of the four RCTs were of high quality. When the RCTs were analyzed, odds ratios (OR) for gabexate mesilate were 0.67 [95% CI (0.31 to approximately 1.47), p = 0.32] for PEP, 3.78 [95% CI (0.62 to approximately 22.98), p = 0.15] for severe PEP, 0.68 [95% CI (0.19 to approximately 2.43), p = 0.56] for the case-fatality of PEP, 0.88 [95% CI (0.72 to approximately 1.07), p = 0.20] for post-ERCP hyperamylasemia, 0.69 [95% CI (0.39 to approximately 1.21), p = 0.19] for post-ERCP abdominal pain, thus indicating no beneficial effects of gabexate on acute pancreatitis, the death rate of PEP, hyperamylasemia and abdominal pain. No evidence of publication bias was found.

Conclusion: Gabexate mesilate can not prevent the pancreatic injury after ERCP. It is not recommended for the use of gabexate mesilate in the prophylaxis of PEP.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Identification of eligible randomized controlled trials from different medicine databases.
Figure 2
Figure 2
Effect of gabexate on the frequency of ERCP-related acute pancreatitis, severe pancreatitis, case-fatality ratio, post-ERCP hyperamylasemia and post-ERCP abdominal pain.
Figure 3
Figure 3
Sensitivity-analysis I: The study of the longest treatment duration [4] was excluded.
Figure 4
Figure 4
Sensitivity-analysis II: The study of the shortest treatment duration [9] was excluded.
Figure 5
Figure 5
A funnel plot to explore publication bias.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Freeman ML, Nelson DB, Sherman S, Haber GB, Herman ME, Dorsher PJ, Moore JP, Fennerty MB, Ryan ME, Shaw MJ, Lande JD, Pheley AM. Complications of endoscopic biliary sphincterotomy. N Engl J Med. 1996;335:909–918. doi: 10.1056/NEJM199609263351301. - DOI - PubMed
    1. Sherman S, Lehman GA. ERCP- and endoscopic sphincterotomy-induced pancreatitis. Pancreas. 1991;6:350–367. doi: 10.1097/00006676-199105000-00013. - DOI - PubMed
    1. Cotton PB, Lehman G, Vennes J, Geenen JE, Russell RC, Meyers WC, Liguory C, Nickl N. Endoscopic sphincterotomy complications and their management: an attempt at consensus. Gastrointest Endosc. 1991;37:383–393. - PubMed
    1. Cavallini G, Tittobello A, Frulloni L, Masci E, Mariana A, Di Francesco V. Gabexate for the prevention of pancreatic damage related to endoscopic retrograde cholangiopancreatography. Gabexate in digestive endoscopy--Italian Group. N Engl J Med. 1996;335:919–923. doi: 10.1056/NEJM199609263351302. - DOI - PubMed
    1. Benini L, Angelini G, Lavarini E, Brocco G, Cavallini G, Merigo F. Effect of a new enzyme inhibitor (Gabexate Mesilate- FOY) on hyperenzymemia induced by ERCP. A double blind study [abstract]. Digestion. 1985;32:A165.

Publication types

MeSH terms