Clinical efficacy of endoscopic retrograde cholangiopancreatography in the treatment of acute biliary pancreatitis: a meta-analysis

Introduction: Acute biliary pancreatitis (ABP) is a type of acute abdomen caused by biliary tract diseases that trigger outflow obstruction, hypertension of the pancreatic duct, and subsequent pancreatic autodigestion.

Aim: To investigate the clinical efficacy of endoscopic retrograde cholangiopancreatography (ERCP) in the treatment of ABP.

Material and methods: A comprehensive literature search was performed on four databases (PubMed/WOS/CNKI/Wanfang) to select randomized controlled trials on ERCP for ABP published between 2010 and 2022. Relevant data were then extracted from the eligible studies. Subsequently, meta-analysis and sensitivity analysis were performed using Stata 16.0 statistical software. Publication bias was determined using funnel plots created by the Begg method.

Results: A total of 1639 patients with ABP were included, of whom 823 were in the observation (ERCP or ERCP + endoscopic sphincterotomy) group and 816 in the control (conservative treatment) group. The observation group demonstrated a higher response rate, lower incidence of complications, and superior postoperative abdominal pain relief time, time to intestinal exhaust, serum amylase recovery time and hospital stay than the control group (p < 0.05). In addition, biochemical parameters and inflammatory factor levels (Tbil/WBC/CRP/TNF-α) were significantly better after treatment in the observation group than in the control group (p < 0.05).

Conclusions: Collectively, ERCP in the treatment of ABP was associated with relief of abdominal pain, accelerated intestinal exhaust and serum amylase recovery, and effective improvements in serum biochemical parameters and inflammatory factor levels.