Prophylactic Corticosteroids Do Not Prevent Post-ERCP Pancreatitis: A Meta-Analysis of Randomized Controlled Trials

Background: Data regarding the use of corticosteroids for the prevention of post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis are conflicting. The aim of this meta-analysis was to compare corticosteroids with placebo for prevention of post-ERCP pancreatitis. Methods: Multiple databases including MEDLINE, EMBASE, Cochrane controlled trials register, the Cochrane Library, Science Citation Index, Google Scholar and Google updated to June 2007 were searched to retrieve the relevant randomized controlled trials. Primary outcome measure was post-ERCP pancreatitis. Results: Six randomized controlled trials involving 2,448 patients were identified. The analysis showed that corticosteroids did not prevent post-ERCP pancreatitis (OR 1.13:95% CI [0.88,1.46]). Subsequent sensitivity and subgroup analyses according to different criteria all confirmed these results. Conclusions: Based on available evidence, prophylactic corticosteroids do not reduce the incidence of post-ERCP pancreatitis.