| Sumario: | Background: Acute pancreatitis is the most and severe complication of post-ERCP (Endoscopic Retrograde Cholangiopancreatographies). The pathogenesis of post-ERCP acute pancreatitis could be mitigated by pancreatic stent placement. More and more evidence for the efficacy of pancreatic stents in reducing post-ERCP pancreatitis continues to accumulate. And we performed a meta analysis of RCTs (randomized controlled trials) to evaluate the effect of pancreatic stent placement for the post-ERCP pancreatitis. Methods: We identified eligible studies from PubMed and EMbase electronic databases. All studies data were extracted by two independent authors. We first time performed a subgroup analysis according to the areas of Europe-America and Asia-Pacific. Relative risks (RRs), and 95% confidence intervals (CIs) were calculated and heterogeneity was assessed with the 12 test. Publication bias was assessed by visually inspecting of the Begg funnel plot. We evaluated the presence of publication bias by using the Begg and Egger tests. Results: Fourteen studies with a total of 1469 patients met the inclusion criteria. Pancreatic stent placement was significantly reduction the incidence of post-ERCP pancreatitis(RR 0.35 95%CI0.25 to 0.47;P < 0.01). The subgroup analysis according to the areas of Europe-America and Asia-Pacific suggested that pancreatic stent placement were significantly decreased the incidence of post-ERCP pancreatitis respectively (RR 0.33 95%CI O.I9to 0.58; P < 0.01) and (RR 0.40 95%C10.28 to 0.56; P < 0.01). Publication bias using Egger's and Begg's tests (Egger's test P=0.002). Conclusion: This meta-analysis demonstrates that pancreatic stent placement for the prevention of post-ERCP pancreatitis is beneficial. However, because the publication bias exist and relevant evidence are still limited, we should treat our meta analyses with caution attitudes. Further large-scale, more high quality randomized controlled trials are need to demonstrate the pancreatic stent placment safety.
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