Scolaris Content Display Scolaris Content Display

Cochrane Database of Systematic Reviews

Intervenciones farmacológicas para la pancreatitis aguda

Información

DOI:
https://doi.org/10.1002/14651858.CD011384.pub2Copiar DOI
Base de datos:
  1. Cochrane Database of Systematic Reviews
Versión publicada:
  1. 21 abril 2017see what's new
Tipo:
  1. Intervention
Etapa:
  1. Review
Grupo Editorial Cochrane:

  1. Grupo Cochrane de Salud digestiva

Copyright:
  1. Copyright © 2017 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.

Cifras del artículo

Altmetric:

Citado por:

Citado 0 veces por enlace Crossref Cited-by

Contraer

Autores

  • Elisabetta Moggia

    Department of General and Digestive Surgery, IRCCS Humanitas Research Hospital, Milan, Italy

  • Rahul Koti

    Department of Surgery, Royal Free Campus, UCL Medical School, London, UK

  • Ajay P Belgaumkar

    Dept of Upper GI Surgery, Ashford and St Peter's NHS Trust, Chertsey, UK

  • Federico Fazio

    HPB and Liver Transplant Surgery, Royal Free Hospital, NHS Foundation Trust, London, UK

  • Stephen P Pereira

    UCL Institute for Liver and Digestive Health, Royal Free Hospital Campus, London, UK

  • Brian R Davidson

    Department of Surgery, Royal Free Campus, UCL Medical School, London, UK

  • Kurinchi Selvan Gurusamy

    Correspondencia a: Department of Surgery, Royal Free Campus, UCL Medical School, London, UK

    [email protected]

Contributions of authors

EM selected studies and extracted the data for more than half the studies identified by screening and completed the tables detailing the characteristics of included and excluded studies. FF helped EM with data extraction. RK selected studies and extracted the data for the remaining studies. AB screened the references. SP and BRD critically commented on the review. KG screened the references, selected studies, extracted the data, analysed the data, and wrote the review.

Sources of support

Internal sources

  • University College London, UK.

External sources

  • National Institute for Health Research, UK.

Declarations of interest

This report is independent research funded by the National Institute for Health Research (NIHR Cochrane Programme Grants, 13/89/03 ‐ Evidence‐based diagnosis and management of upper digestive, hepato‐biliary, and pancreatic disorders). The views expressed in this publication are those of the authors and not necessarily those of the NHS, the National Institute for Health Research or the Department of Health.

Acknowledgements

We thank Karin Dearness, Managing Editor, Cochrane Upper Gastrointestinal and Pancreatic Diseases (UGPD) Group for providing administrative and logistical support for the conduct of the current review, and Racquel Simpson, Trials Search Co‐ordinator, Cochrane Upper Gastrointestinal and Pancreatic Diseases (UGPD) Group for developing and executing the search strategies.

We thank the copy editors and Cochrane Editorial Unit for their comments.

Version history

Published

Title

Stage

Authors

Version

2017 Apr 21

Pharmacological interventions for acute pancreatitis

Review

Elisabetta Moggia, Rahul Koti, Ajay P Belgaumkar, Federico Fazio, Stephen P Pereira, Brian R Davidson, Kurinchi Selvan Gurusamy

https://doi.org/10.1002/14651858.CD011384.pub2

2014 Nov 13

Pharmacological interventions for acute pancreatitis: a network meta‐analysis

Protocol

Kurinchi Selvan Gurusamy

https://doi.org/10.1002/14651858.CD011384

Differences between protocol and review

  1. We did not combine somatostatin and somatostatin analogues. This is to avoid further clinical heterogeneity.

  2. We reported sepsis separately under serious adverse events due to its importance as an important clinical outcome.

Keywords

MeSH

Medical Subject Headings (MeSH) Keywords

Medical Subject Headings Check Words

Humans;

PICO

Population
Intervention
Comparison
Outcome

El uso y la enseñanza del modelo PICO están muy extendidos en el ámbito de la atención sanitaria basada en la evidencia para formular preguntas y estrategias de búsqueda y para caracterizar estudios o metanálisis clínicos. PICO son las siglas en inglés de cuatro posibles componentes de una pregunta de investigación: paciente, población o problema; intervención; comparación; desenlace (outcome).

Para saber más sobre el uso del modelo PICO, puede consultar el Manual Cochrane.

Study flow diagram.
Figuras y tablas -
Figure 1

Study flow diagram.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
Figuras y tablas -
Figure 2

Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Risk of bias summary: review authors' judgements about each risk of bias item for each included study.
Figuras y tablas -
Figure 3

Risk of bias summary: review authors' judgements about each risk of bias item for each included study.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Funnel plot of short‐term mortality indicating no evidence of reporting bias.
Figuras y tablas -
Figure 4

Funnel plot of short‐term mortality indicating no evidence of reporting bias.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Funnel plot of infected pancreatic necrosis indicating no evidence of reporting bias.
Figuras y tablas -
Figure 5

Funnel plot of infected pancreatic necrosis indicating no evidence of reporting bias.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Funnel plot of requirement for additional invasive intervention indicating no evidence of reporting bias.
Figuras y tablas -
Figure 6

Funnel plot of requirement for additional invasive intervention indicating no evidence of reporting bias.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Funnel plot of serious adverse events (number) indicating that trials with lower precision favoured antibiotics without matching trials with lower precision which showed no effect or favouring control.
Figuras y tablas -
Figure 7

Funnel plot of serious adverse events (number) indicating that trials with lower precision favoured antibiotics without matching trials with lower precision which showed no effect or favouring control.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Funnel plot of adverse events (number) indicating that trials with lower precision favoured antibiotics while trials with greater precision favoured control.
Figuras y tablas -
Figure 8

Funnel plot of adverse events (number) indicating that trials with lower precision favoured antibiotics while trials with greater precision favoured control.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Network plot showing the treatment comparisons that included short‐term mortality. The circles represent treatments while the lines represent the comparisons between the treatments.
Figuras y tablas -
Figure 9

Network plot showing the treatment comparisons that included short‐term mortality. The circles represent treatments while the lines represent the comparisons between the treatments.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 1 Acute pancreatitis, Outcome 1 Short‐term mortality.
Figuras y tablas -
Analysis 1.1

Comparison 1 Acute pancreatitis, Outcome 1 Short‐term mortality.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 1 Acute pancreatitis, Outcome 2 Serious adverse events (proportion).
Figuras y tablas -
Analysis 1.2

Comparison 1 Acute pancreatitis, Outcome 2 Serious adverse events (proportion).

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 1 Acute pancreatitis, Outcome 3 Serious adverse events (number).
Figuras y tablas -
Analysis 1.3

Comparison 1 Acute pancreatitis, Outcome 3 Serious adverse events (number).

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 1 Acute pancreatitis, Outcome 4 Organ failure.
Figuras y tablas -
Analysis 1.4

Comparison 1 Acute pancreatitis, Outcome 4 Organ failure.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 1 Acute pancreatitis, Outcome 5 Infected pancreatic necrosis.
Figuras y tablas -
Analysis 1.5

Comparison 1 Acute pancreatitis, Outcome 5 Infected pancreatic necrosis.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 1 Acute pancreatitis, Outcome 6 Sepsis.
Figuras y tablas -
Analysis 1.6

Comparison 1 Acute pancreatitis, Outcome 6 Sepsis.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 1 Acute pancreatitis, Outcome 7 Adverse events (proportion).
Figuras y tablas -
Analysis 1.7

Comparison 1 Acute pancreatitis, Outcome 7 Adverse events (proportion).

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 1 Acute pancreatitis, Outcome 8 Adverse events (number).
Figuras y tablas -
Analysis 1.8

Comparison 1 Acute pancreatitis, Outcome 8 Adverse events (number).

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 1 Acute pancreatitis, Outcome 9 Requirement for additional invasive intervention.
Figuras y tablas -
Analysis 1.9

Comparison 1 Acute pancreatitis, Outcome 9 Requirement for additional invasive intervention.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 1 Acute pancreatitis, Outcome 10 Endoscopic or radiological drainage of collections.
Figuras y tablas -
Analysis 1.10

Comparison 1 Acute pancreatitis, Outcome 10 Endoscopic or radiological drainage of collections.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 2 Acute necrotising pancreatitis, Outcome 1 Short‐term mortality.
Figuras y tablas -
Analysis 2.1

Comparison 2 Acute necrotising pancreatitis, Outcome 1 Short‐term mortality.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 2 Acute necrotising pancreatitis, Outcome 2 Serious adverse events (proportion).
Figuras y tablas -
Analysis 2.2

Comparison 2 Acute necrotising pancreatitis, Outcome 2 Serious adverse events (proportion).

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 2 Acute necrotising pancreatitis, Outcome 3 Serious adverse events (number).
Figuras y tablas -
Analysis 2.3

Comparison 2 Acute necrotising pancreatitis, Outcome 3 Serious adverse events (number).

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 2 Acute necrotising pancreatitis, Outcome 4 Organ failure.
Figuras y tablas -
Analysis 2.4

Comparison 2 Acute necrotising pancreatitis, Outcome 4 Organ failure.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 2 Acute necrotising pancreatitis, Outcome 5 Infected pancreatic necrosis.
Figuras y tablas -
Analysis 2.5

Comparison 2 Acute necrotising pancreatitis, Outcome 5 Infected pancreatic necrosis.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 2 Acute necrotising pancreatitis, Outcome 6 Sepsis.
Figuras y tablas -
Analysis 2.6

Comparison 2 Acute necrotising pancreatitis, Outcome 6 Sepsis.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 3 Severe acute pancreatitis, Outcome 1 Short‐term mortality.
Figuras y tablas -
Analysis 3.1

Comparison 3 Severe acute pancreatitis, Outcome 1 Short‐term mortality.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 3 Severe acute pancreatitis, Outcome 2 Serious adverse events (proportion).
Figuras y tablas -
Analysis 3.2

Comparison 3 Severe acute pancreatitis, Outcome 2 Serious adverse events (proportion).

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 3 Severe acute pancreatitis, Outcome 3 Serious adverse events (number).
Figuras y tablas -
Analysis 3.3

Comparison 3 Severe acute pancreatitis, Outcome 3 Serious adverse events (number).

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 3 Severe acute pancreatitis, Outcome 4 Organ failure.
Figuras y tablas -
Analysis 3.4

Comparison 3 Severe acute pancreatitis, Outcome 4 Organ failure.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 3 Severe acute pancreatitis, Outcome 5 Infected pancreatic necrosis.
Figuras y tablas -
Analysis 3.5

Comparison 3 Severe acute pancreatitis, Outcome 5 Infected pancreatic necrosis.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 3 Severe acute pancreatitis, Outcome 6 Sepsis.
Figuras y tablas -
Analysis 3.6

Comparison 3 Severe acute pancreatitis, Outcome 6 Sepsis.

Ir a la figura de la revisiónAbrir en una pestaña nueva
Summary of findings for the main comparison. Summary of findings (mortality)

Pharmacological interventions for treatment of acute severe pancreatitis (mortality)

Patient or population: people with acute pancreatitis
Settings: secondary or tertiary setting
Intervention: various treatments
Control: inactive control

Outcomes

Illustrative comparative risks* (95% CI)

Relative effect
(95% CI)

No of participants
(studies)

Quality of the evidence
(GRADE)

Assumed risk

Inactive control

Corresponding risk

Various treatments

Short‐term mortality

Follow‐up: up to 3 months

Antibiotics

OR 0.81
(0.57 to 1.15)

1058
(17 studies)

⊕⊝⊝⊝
Very lowa,b,c

120 per 1000

99 per 1000
(72 to 135)

Antioxidants

OR 2.01
(0.53 to 7.56)

163
(4 studies)

⊕⊝⊝⊝
Very lowa,b,c

120 per 1000

215 per 1000
(68 to 508)

Aprotinin

OR 0.68
(0.40 to 1.14)

651
(7 studies)

⊕⊝⊝⊝
Very lowa,b,c

120 per 1000

85 per 1000
(52 to 135)

Calcitonin

OR 0.55
(0.15 to 2.00)

125
(2 studies)

⊕⊝⊝⊝
Very low1,²,3

120 per 1000

69 per 1000
(20 to 214)

Cimetidine

OR 1.00
(0.06 to 17.18)

40
(1 study)

⊕⊝⊝⊝
Very lowa,b,c

120 per 1000

120 per 1000
(8 to 701)

EDTA

OR 0.94
(0.12 to 7.08)

64
(1 study)

⊕⊝⊝⊝
Very low1,²,3

120 per 1000

113 per 1000
(17 to 491)

Gabexate

OR 0.79
(0.48 to 1.30)

576
(5 studies)

⊕⊝⊝⊝
Very lowa,b,c

120 per 1000

98 per 1000
(62 to 151)

Glucagon

OR 0.97
(0.51 to 1.87)

409
(5 studies)

⊕⊝⊝⊝
Very low1,²,3

120 per 1000

117 per 1000
(65 to 203)

Iniprol

OR 0.14
(0.01 to 1.67)

24
(1 study)

⊕⊝⊝⊝
Very lowa,b,c

120 per 1000

19 per 1000
(2 to 185)

Lexipafant

OR 0.55
(0.30 to 1.01)

423
(3 studies)

⊕⊝⊝⊝
Very low1,²,3

120 per 1000

70 per 1000
(40 to 121)

Octreotide

OR 0.76
(0.47 to 1.23)

927
(6 studies)

⊕⊝⊝⊝
Very lowa,b,c

120 per 1000

94 per 1000
(60 to 143)

Probiotics

OR 1.70
(0.87 to 3.30)

358
(2 studies)

⊕⊝⊝⊝
Very lowa,b,c,d

120 per 1000

188 per 1000
(106 to 310)

Activated protein C

OR 8.56
(0.41 to 180.52)

32
(1 study)

⊕⊝⊝⊝
Very lowa,b,c

120 per 1000

539 per 1000
(52 to 961)

Somatostatin

OR 0.57
(0.29 to 1.10)

493
(6 studies)

⊕⊝⊝⊝
Very lowa,b,c

120 per 1000

72 per 1000
(39 to 130)

Somatostatin plus omeprazole

OR 0.23
(0.05 to 1.11)

140
(1 study)

⊕⊝⊝⊝
Very lowa,b,c

120 per 1000

30 per 1000
(6 to 132)

Somatostatin plus ulinastatin

OR 0.43
(0.15 to 1.23)

122
(1 study)

⊕⊝⊝⊝
Very lowa,b,c

120 per 1000

55 per 1000
(20 to 144)

Thymosin

Not estimable

24
(1 study)

⊕⊝⊝⊝
Very lowa,b,c

120 per 1000

not estimable

Ulinastatin

OR 0.45
(0.12 to 1.72)

132
(2 studies)

⊕⊝⊝⊝
Very lowa,b,c

120 per 1000

58 per 1000
(16 to 190)

Long‐term mortality
Follow‐up: 1 year

None of the trials with inactive treatment in the control group reported long‐term mortality.

*The basis for the assumed risk is the average control group proportion across all comparisons. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).

CI: confidence intervals; OR: odds ratio; EDTA: ethylenediaminetetraacetic acid.

GRADE Working Group grades of evidence
High quality: further research is very unlikely to change our confidence in the estimate of effect.
Moderate quality: further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.
Low quality: further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.
Very low quality: we are very uncertain about the estimate.

aRisk of bias: downgraded by one level.
bImprecision: downgraded one level for wide confidence intervals.
cImprecision: downgraded one level for small sample size.
dHeterogeneity: downgraded one level for lack of overlap of confidence intervals and high I².

Figuras y tablas -
Summary of findings for the main comparison. Summary of findings (mortality)
Ir a la tabla de la revisión
Summary of findings 2. Summary of findings (other primary outcomes)

Pharmacological interventions for treatment of acute severe pancreatitis (other outcomes)

Patient or population: people with acute pancreatitis
Settings: secondary or tertiary setting
Intervention: various treatments
Control: inactive control

Outcomes

Illustrative comparative risks* (95% CI)

Relative effect
(95% CI)

No of participants
(studies)

Quality of the evidence
(GRADE)

Assumed risk

Corresponding risk

Inactive control

Various treatments

Serious adverse events (proportion)

Follow‐up: up to 3 months

Antibiotics

OR 0.65
(0.37 to 1.15)

304
(5 studies)

⊕⊝⊝⊝
Very lowa,b,c

147 per 1000

101 per 1000
(60 to 166)

Antioxidants

OR 1.98
(0.48 to 8.13)

82
(2 studies)

⊕⊝⊝⊝
Very lowa,b,c

147 per 1000

255 per 1000
(77 to 584)

EDTA

OR 0.52
(0.11 to 2.39)

64
(1 study)

⊕⊝⊝⊝
Very lowa,b,c

147 per 1000

83 per 1000
(19 to 292)

Gabexate

OR 1.31
(0.31 to 5.60)

201
(2 studies)

⊕⊝⊝⊝
Very lowa,b,c

147 per 1000

185 per 1000
(51 to 492)

Glucagon

OR 0.29
(0.01 to 7.46)

127
(2 studies)

⊕⊝⊝⊝
Very lowa,b,c

147 per 1000

48 per 1000
(2 to 563)

Octreotide

OR 1.73
(0.61 to 4.93)

58
(1 study)

⊕⊝⊝⊝
Very lowa,b,c,d

147 per 1000

230 per 1000
(95 to 460)

Somatostatin

OR 1.07
(0.35 to 3.27)

111
(2 studies)

⊕⊝⊝⊝
Very lowa,b,c,d

147 per 1000

156 per 1000
(57 to 361)

Serious adverse events (number)

Follow‐up: up to 3 months

Antibiotics

Rate ratio0.86
(0.68 to 1.07)

716
(12 studies)

⊕⊝⊝⊝
Very lowa,b,c

437 per 1000

374 per 1000
(298 to 469)

Antioxidants

Rate ratio0.22
(0.02 to 2.21)

71
(2 studies)

⊕⊝⊝⊝
Very lowa,b,c

437 per 1000

94 per 1000
(9 to 967)

Aprotinin

Rate ratio0.79
(0.49 to 1.29)

264
(3 studies)

⊕⊝⊝⊝
Very lowa,b,c

437 per 1000

345 per 1000
(212 to 562)

Cimetidine

Rate ratio1.00
(0.20 to 4.95)

60
(1 study)

⊕⊝⊝⊝
Very lowa,b,c

437 per 1000

437 per 1000
(88 to 2165)

EDTA

Rate ratio0.94
(0.19 to 4.65)

64
(1 study)

⊕⊝⊝⊝
Very lowa,b,c

437 per 1000

411 per 1000
(83 to 2034)

Gabexate

Rate ratio0.86
(0.64 to 1.15)

375
(3 studies)

⊕⊝⊝⊝
Very lowa,b,c

437 per 1000

375 per 1000
(279 to 503)

Glucagon

Rate ratio1.00
(0.02 to 50.40)

68
(1 study)

⊕⊝⊝⊝
Very lowa,b,c

437 per 1000

437 per 1000
(9 to 22027)

Lexipafant

rate ratio0.67
(0.46 to 0.96)

290
(1 study)

⊕⊝⊝⊝
Very lowa,b,c

437 per 1000

292 per 1000
(203 to 420)

Octreotide

Rate ratio0.74
(0.60 to 0.89)

770
(5 studies)

⊕⊝⊝⊝
Very lowa,b,c

437 per 1000

321 per 1000
(264 to 391)

Probiotics

Rate ratio0.94
(0.65 to 1.36)

397
(3 studies)

⊕⊝⊝⊝
Very lowa,b,c,d

437 per 1000

412 per 1000
(286 to 595)

Somatostatin

Rate ratio1.03
(0.66 to 1.59)

257
(3 studies)

⊕⊝⊝⊝
Very lowa,b,c

437 per 1000

449 per 1000
(290 to 695)

Somatostatin plus omeprazole

Rate ratio0.36
(0.19 to 0.70)

140
(1 study)

⊕⊕⊝⊝
Lowa,b

437 per 1000

159 per 1000
(82 to 308)

Somatostatin plus ulinastatin

Rate ratio0.30
(0.15 to 0.60)

122
(1 study)

⊕⊕⊝⊝
Lowa,b

437 per 1000

133 per 1000
(68 to 262)

Organ failure

Follow‐up: up to 3 months

Antibiotics

OR 0.78
(0.44 to 1.38)

258
(5 studies)

⊕⊝⊝⊝
Very lowa,b,c

289 per 1000

241 per 1000
(152 to 360)

Antioxidants

OR 0.92
(0.39 to 2.12)

163
(4 studies)

⊕⊝⊝⊝
Very lowa,b,c

289 per 1000

271 per 1000
(138 to 463)

Gabexate

OR 0.32
(0.01 to 8.25)

50
(1 study)

⊕⊝⊝⊝
Very lowa,b,c

289 per 1000

115 per 1000
(5 to 770)

Lexipafant

OR 0.68
(0.36 to 1.27)

340
(2 studies)

⊕⊝⊝⊝
Very lowa,b,c

289 per 1000

216 per 1000
(128 to 341)

Octreotide

OR 0.51
(0.27 to 0.97)

430
(3 studies)

⊕⊝⊝⊝
Very lowa,b,c,d

289 per 1000

173 per 1000
(99 to 284)

Probiotics

OR 0.80
(0.26 to 2.47)

358
(2 studies)

⊕⊝⊝⊝
Very lowa,b,c,d

289 per 1000

246 per 1000
(95 to 501)

Ulinastatin

OR 0.27
(0.01 to 6.67)

129
(2 studies)

⊕⊝⊝⊝
Very lowa,b,c,d

289 per 1000

100 per 1000
(5 to 731)

Infected pancreatic necrosis

Follow‐up: up to 3 months

Antibiotics

OR 0.82
(0.53 to 1.25)

714
(11 studies)

⊕⊝⊝⊝
Very lowa,b,c

140 per 1000

118 per 1000
(80 to 169)

Octreotide

OR 0.52
(0.04 to 6.06)

58
(1 study)

⊕⊝⊝⊝
Very lowa,b,c

140 per 1000

78 per 1000
(7 to 497)

Probiotics

OR 1.10
(0.62 to 1.96)

397
(3 studies)

⊕⊝⊝⊝
Very lowa,b,c

140 per 1000

152 per 1000
(92 to 243)

Sepsis

Follow‐up: up to 3 months

Antibiotics

OR 0.42
(0.11 to 1.60)

60
(1 study)

⊕⊝⊝⊝
Very lowa,b,c

122 per 1000

56 per 1000
(15 to 182)

Aprotinin

OR 1.84
(0.49 to 6.96)

103
(2 studies)

⊕⊝⊝⊝
Very lowa,b,c

122 per 1000

204 per 1000
(63 to 492)

Gabexate

OR 1.10
(0.55 to 2.19)

373
(3 studies)

⊕⊝⊝⊝
Very lowa,b,c

122 per 1000

133 per 1000
(71 to 233)

Lexipafant

OR 0.26
(0.08 to 0.83)

290
(1 study)

⊕⊝⊝⊝
Very lowa,b,c

122 per 1000

35 per 1000
(12 to 103)

Octreotide

OR 0.40
(0.05 to 3.53)

340
(2 studies)

⊕⊝⊝⊝
Very lowa,b,c,d

122 per 1000

53 per 1000
(6 to 329)

Probiotics

OR 0.36
(0.10 to 1.36)

62
(1 study)

⊕⊝⊝⊝
Very lowa,b,c

122 per 1000

48 per 1000
(13 to 159)

Health‐related quality of life

None of the trials reported this outcome.

*The basis for the assumed risk is the average control group proportion across all comparisons. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).

CI: confidence intervals; OR = odds ratio; EDTA = ethylenediaminetetraacetic acid.

GRADE Working Group grades of evidence
High quality: further research is very unlikely to change our confidence in the estimate of effect.
Moderate quality: further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.
Low quality: further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.
Very low quality: we are very uncertain about the estimate.

aRisk of bias: downgraded by one level.
bImprecision: downgraded one level for wide confidence intervals.
cImprecision: downgraded one level for small sample size.
dHeterogeneity: downgraded one level for lack of overlap of confidence intervals and high I².

Figuras y tablas -
Summary of findings 2. Summary of findings (other primary outcomes)
Ir a la tabla de la revisión
Table 1. Characteristics of included studies (ordered by comparisons)

Study name

No of participants randomised

Postrandomisation dropouts

No of participants for whom outcome was reported

Treatment 1

Treatment 2

Selection bias

Performance and detection bias

Attrition bias

Selective reporting bias

Other bias

Pettila 2010

32

0

32

Activated protein C

Placebo

Unclear

Low

Low

High

High

Barreda 2009

80

22

58

Antibiotics

No active intervention

Unclear

Unclear

High

Low

Unclear

Delcenserie 1996

23

0

23

Antibiotics

No active intervention

Unclear

Unclear

Low

Low

Unclear

Delcenserie 2001

81

Not stated

81

Antibiotics

No active intervention

Unclear

Unclear

Unclear

Low

Unclear

Dellinger 2007

100

0

100

Antibiotics

Placebo

Low

Low

Low

Low

High

Finch 1976

62

4

58

Antibiotics

No active intervention

Unclear

Unclear

High

Low

Unclear

Garcia‐Barrasa 2009

46

5

41

Antibiotics

Placebo

Unclear

Low

High

Low

Low

Hejtmankova 2003

41

Not stated

41

Antibiotics

No active intervention

Unclear

Unclear

Unclear

Low

Unclear

Isenmann 2004

119

5

114

Antibiotics

Placebo

Unclear

Low

High

High

High

Llukacaj 2012

80

Not stated

80

Antibiotics

Placebo

Unclear

Low

Unclear

High

Unclear

Luiten 1995

109

7

102

Antibiotics

No active intervention

Unclear

Unclear

High

Low

Unclear

Nordback 2001

90

32

58

Antibiotics

Placebo

Unclear

Unclear

High

Low

Unclear

Poropat 2015

47

0

47

Antibiotics

No active intervention

Unclear

Unclear

Low

Low

Unclear

Pederzoli 1993a

74

Not stated

74

Antibiotics

No active intervention

Unclear

Unclear

Low

Low

Unclear

Rokke 2007

73

0

73

Antibiotics

No active intervention

Unclear

High

Low

Low

High

Sainio 1995

60

0

60

Antibiotics

No active intervention

Unclear

Unclear

Low

Low

Unclear

Spicak 2002

63

Not stated

63

Antibiotics

No active intervention

Unclear

Unclear

Unclear

Low

Unclear

Spicak 2003

41

Not stated

41

Antibiotics

No active intervention

Unclear

Unclear

Unclear

Low

Unclear

Xue 2009

59

3

56

Antibiotics

No active intervention

Unclear

Unclear

High

Low

Low

Bansal 2011

44

5

39

Antioxidants

No active intervention

Unclear

High

High

Low

Low

Birk 1994

20

Not stated

20

Antioxidants

No active intervention

Unclear

Unclear

Unclear

High

Unclear

Marek 1999

73

0

73

Antioxidants

Placebo

Unclear

Unclear

Low

High

Unclear

Sateesh 2009

56

3

53

Antioxidants

No active intervention

Unclear

High

High

Low

Unclear

Siriwardena 2007

43

0

43

Antioxidants

Placebo

Low

Low

Low

Low

High

Vege 2015

28

Not stated

28

Antioxidants

Placebo

Unclear

Low

Low

Low

Unclear

Chooklin 2007

34

Not stated

34

Antioxidants plus Corticosteroids

No active intervention

Unclear

Unclear

Unclear

High

Unclear

MRC Multicentre Trial 1977

(this is a 3‐armed trial; the numbers stated included all 3 arms)

264

7

257

Aprotinin

Placebo

Unclear

Low

High

High

High

Balldin 1983

55

Not stated

55

Aprotinin

No active intervention

Unclear

Unclear

Unclear

Low

High

Berling 1994

48

Not stated

48

Aprotinin

No active intervention

Unclear

Low

Low

Low

High

Imrie 1978

161

Not stated

161

Aprotinin

Placebo

Unclear

Low

Unclear

Low

High

Imrie 1980

50

Not stated

50

Aprotinin

Placebo

Unclear

Low

Unclear

High

Unclear

Storck 1968

43

Not stated

43

Aprotinin

Placebo

Unclear

Low

Unclear

High

Unclear

Trapnell 1974

105

Not stated

105

Aprotinin

Placebo

Low

Low

Unclear

High

High

MRC Multicentre Trial 1977

(this is a 3‐armed trial; the numbers stated included all 3 arms)

264

7

257

Aprotinin

Glucagon

Unclear

Low

High

High

High

Goebell 1979

94

Not stated

94

Calcitonin

Placebo

Unclear

Low

Unclear

Low

Unclear

Martinez 1984

31

0

31

Calcitonin

Placebo

Unclear

Unclear

Low

High

Unclear

Perezdeoteyza 1980

40

Not stated

40

Cimetidine

Placebo

Unclear

Low

Unclear

High

Unclear

Sillero 1981

60

Not stated

60

Cimetidine

Placebo

Low

Unclear

Unclear

High

Unclear

Tykka 1985

64

0

64

EDTA

Placebo

Unclear

Low

Low

Low

High

Frulloni 1994

116

Not stated

116

Gabexate

Aprotinin

Unclear

Unclear

Unclear

Low

Unclear

Pederzoli 1993b

199

17

182

Gabexate

Aprotinin

Unclear

Low

High

Low

Unclear

Buchler 1993

223

Not stated

223

Gabexate

Placebo

Low

Low

Low

Low

Unclear

Chen 2000

52

Not stated

52

Gabexate

Placebo

Unclear

Unclear

Unclear

Low

Unclear

Freise 1986

50

Not stated

50

Gabexate

Placebo

Unclear

Low

Unclear

Low

Unclear

Goebell 1988

162

11

151

Gabexate

Placebo

Unclear

Low

High

Low

Unclear

Valderrama 1992

105

5

100

Gabexate

Placebo

Low

Low

High

Low

High

Kirsch 1978

150

Not stated

150

Glucagon

Atropine

Unclear

Unclear

Unclear

Low

Unclear

MRC Multicentre Trial 1977

(this is a 3‐armed trial; the numbers stated included all 3 arms)

264

7

257

Glucagon

Placebo

Unclear

Unclear

Unclear

Low

High

Debas 1980

66

Not stated

66

Glucagon

Placebo

Unclear

Low

Unclear

Low

Unclear

Dürr 1978

69

Not stated

69

Glucagon

Placebo

Unclear

Low

Unclear

High

Unclear

Kalima 1980

80

9

71

Glucagon

Placebo

Unclear

Unclear

High

Low

Unclear

Kronborg 1980

22

Not stated

22

Glucagon

Placebo

Unclear

Low

Unclear

High

Unclear

Gilsanz 1978

62

Not stated

62

Glucagon

Oxyphenonium

Unclear

Low

Unclear

Low

Unclear

Hansky 1969

24

Not stated

24

Iniprol

No active intervention

Unclear

High

Unclear

High

High

Johnson 2001

291

1

290

Lexipafant

Placebo

Unclear

Low

High

Low

High

Kingsnorth 1995

83

Not stated

83

Lexipafant

Placebo

Unclear

Low

Unclear

High

High

McKay 1997b

51

1

50

Lexipafant

Placebo

Unclear

Low

High

High

High

Bredkjaer 1988

66

9

57

NSAID

Placebo

Unclear

Unclear

Unclear

High

Unclear

Ebbehøj 1985

30

0

30

NSAID

Placebo

Unclear

Low

Low

High

High

McKay 1997a

58

0

58

Octreotide

Placebo

Low

Low

Low

Low

Unclear

Ohair 1993

180

Not stated

180

Octreotide

Placebo

Unclear

Unclear

Unclear

High

Unclear

Paran 1995

51

13

38

Octreotide

No active intervention

Unclear

High

High

Low

Unclear

Uhl 1999

302

0

302

Octreotide

Placebo

Unclear

Low

Low

Low

High

Wang 2013c

372

Not stated

372

Octreotide

No active intervention

Unclear

Unclear

High

Low

Low

Yang 2012

163

6

157

Octreotide

No active intervention

Unclear

Unclear

High

High

Low

Wang 2013b

354

Not stated

354

Octreotide plus NSAID

Octreotide

Unclear

Unclear

Unclear

High

Unclear

Guo 2015

120

Not stated

120

Octreotide plus ulinastatin

Octreotide

Unclear

Unclear

Unclear

Low

Unclear

Besselink 2008

298

2

296

Probiotics

Placebo

Low

Low

High

Low

High

Olah 2007

83

21

62

Probiotics

No active intervention

Unclear

Low

High

High

Unclear

Plaudis 2010

90

Not stated

58

Probiotics

No active intervention

Unclear

Low

Unclear

High

Unclear

Sharma 2011

50

0

50

Probiotics

Placebo

Unclear

Low

Low

High

High

Zhu 2014

39

Not stated

39

Probiotics

Placebo

Unclear

Low

Unclear

High

Unclear

Grupo Español 1996

70

9

61

Somatostatin

Placebo

Unclear

Low

High

High

Unclear

Choi 1989

71

Not stated

71

Somatostatin

No active intervention

Unclear

Unclear

Unclear

Low

Unclear

Gjørup 1992

63

Not stated

63

Somatostatin

Placebo

Unclear

Low

Unclear

Low

Unclear

Luengo 1994

100

Not stated

100

Somatostatin

No active intervention

Unclear

Low

Unclear

High

Unclear

Moreau 1986

87

3

84

Somatostatin

Placebo

Unclear

Low

Unclear

High

High

Usadel 1985

77

Not stated

77

Somatostatin

Placebo

Unclear

Low

Unclear

High

Unclear

Wang 2013a (this is a 3‐armed trial; the numbers stated included all 3 arms)

183

Not stated

183

Somatostatin

No active intervention

Unclear

Low

Unclear

Low

Low

Yang 1999

48

Not stated

48

Somatostatin

No active intervention

Unclear

Unclear

Unclear

High

Unclear

Xia 2014

140

Not stated

140

Somatostatin plus omeprazole

No active intervention

Unclear

Unclear

Unclear

Low

Unclear

Wang 2013a (this is a 3‐armed trial; the numbers stated included all 3 arms)

183

Not stated

183

Somatostatin plus ulinastatin

Placebo

Unclear

Unclear

Unclear

High

Unclear

Wang 2013a (this is a 3‐armed trial; the numbers stated included all 3 arms)

183

Not stated

183

Somatostatin plus ulinastatin

Somatostatin

Unclear

Low

Unclear

Low

Low

Wang 2016 (this is a 4‐armed trial; the numbers stated included all 4 arms)

492

0

492

Somatostatin plus ulinastatin

Somatostatin

Low

Low

Low

Low

Low

Wang 2016 (this is a 4‐armed trial; the numbers stated included all 4 arms)

492

0

492

Somatostatin plus gabexate

Somatostatin

Low

Low

Low

Low

Low

Wang 2016 (this is a 4‐armed trial; the numbers stated included all 4 arms)

492

0

492

Somatostatin plus ulinastatin plus gabexate

Somatostatin

Low

Low

Low

Low

Low

Wang 2016 (this is a 4‐armed trial; the numbers stated included all 4 arms)

492

0

492

Somatostatin plus ulinastatin

Somatostatin plus gabexate

Low

Low

Low

Low

Low

Wang 2016 (this is a 4‐armed trial; the numbers stated included all 4 arms)

492

0

492

Somatostatin plus ulinastatin plus gabexate

Somatostatin plus gabexate

Low

Low

Low

Low

Low

Wang 2016 (this is a 4‐armed trial; the numbers stated included all 4 arms)

492

0

492

Somatostatin plus ulinastatin plus gabexate

Somatostatin plus ulinastatin

Low

Low

Low

Low

Low

Wang 2011

24

Not stated

24

Thymosin

Placebo

Unclear

Low

Unclear

High

Unclear

Abraham 2013

135

6

129

Ulinastatin

Placebo

Unclear

Low

High

Low

Unclear

Chen 2002a

68

6

62

Ulinastatin

Gabexate

Unclear

Unclear

High

High

Unclear

Chen 2002b

26

1

25

Ulinastatin

Octreotide

Unclear

Unclear

High

High

Unclear
Figuras y tablas -
Table 1. Characteristics of included studies (ordered by comparisons)
Ir a la tabla de la revisión
Table 2. Potential effect modifiers (ordered by comparisons)

Study name

Treatment 1

Treatment 2

Severe pancreatitis

Necrotising pancreatitis

Organ failure

Infection

Pettila 2010

Activated protein C

Placebo

yes

not stated

not stated

not stated

Barreda 2009

Antibiotics

No active intervention

not stated

yes

not stated

not stated

Delcenserie 1996

Antibiotics

No active intervention

yes

not stated

not stated

not stated

Delcenserie 2001

Antibiotics

No active intervention

not stated

yes

not stated

not stated

Dellinger 2007

Antibiotics

Placebo

yes

yes

not stated

no

Finch 1976

Antibiotics

No active intervention

not stated

not stated

not stated

not stated

Garcia‐Barrasa 2009

Antibiotics

Placebo

yes

yes

not stated

not stated

Hejtmankova 2003

Antibiotics

No active intervention

yes

not stated

not stated

not stated

Isenmann 2004

Antibiotics

Placebo

not stated

not stated

not stated

not stated

Llukacaj 2012

Antibiotics

Placebo

not stated

yes

not stated

no

Luiten 1995

Antibiotics

No active intervention

yes

not stated

not stated

no

Nordback 2001

Antibiotics

Placebo

not stated

yes

no

not stated

Pederzoli 1993a

Antibiotics

No active intervention

not stated

yes

not stated

not stated

Rokke 2007

Antibiotics

No active intervention

yes

yes

not stated

not stated

Sainio 1995

Antibiotics

No active intervention

not stated

yes

not stated

not stated

Spicak 2002

Antibiotics

No active intervention

yes

not stated

not stated

not stated

Spicak 2003

Antibiotics

No active intervention

yes

not stated

not stated

not stated

Xue 2009

Antibiotics

No active intervention

yes

yes

not stated

no

Bansal 2011

Antioxidants

No active intervention

not stated

not stated

not stated

not stated

Birk 1994

Antioxidants

No active intervention

yes

not stated

not stated

not stated

Marek 1999

Antioxidants

Placebo

not stated

not stated

not stated

not stated

Sateesh 2009

Antioxidants

No active intervention

not stated

not stated

not stated

not stated

Siriwardena 2007

Antioxidants

Placebo

not stated

not stated

not stated

not stated

Vege 2015

Antioxidants

Placebo

not stated

not stated

not stated

not stated

Chooklin 2007

Antioxidants plus corticosteroids

No active intervention

yes

not stated

not stated

not stated

Balldin 1983

Aprotinin

No active intervention

yes

not stated

not stated

not stated

Berling 1994

Aprotinin

No active intervention

yes

not stated

not stated

not stated

Imrie 1978

Aprotinin

Placebo

not stated

not stated

not stated

not stated

Imrie 1980

Aprotinin

Placebo

not stated

not stated

not stated

not stated

MRC Multicentre Trial 1977

Aprotinin

Placebo

not stated

not stated

not stated

not stated

Storck 1968

Aprotinin

Placebo

not stated

not stated

not stated

not stated

Trapnell 1974

Aprotinin

Placebo

not stated

not stated

not stated

not stated

Goebell 1979

Calcitonin

Placebo

not stated

not stated

not stated

not stated

Martinez 1984

Calcitonin

Placebo

yes

not stated

not stated

not stated

Perezdeoteyza 1980

Cimetidine

Placebo

not stated

not stated

not stated

not stated

Sillero 1981

Cimetidine

Placebo

not stated

not stated

not stated

not stated

Tykka 1985

EDTA

Placebo

not stated

not stated

not stated

not stated

Buchler 1993

Gabexate

Placebo

not stated

not stated

not stated

not stated

Chen 2000

Gabexate

Placebo

yes

not stated

yes

not stated

Freise 1986

Gabexate

Placebo

not stated

not stated

not stated

not stated

Goebell 1988

Gabexate

Placebo

not stated

not stated

not stated

not stated

Valderrama 1992

Gabexate

Placebo

not stated

not stated

not stated

not stated

Debas 1980

Glucagon

Placebo

not stated

not stated

not stated

not stated

Dürr 1978

Glucagon

Placebo

not stated

not stated

not stated

not stated

Kalima 1980

Glucagon

Placebo

not stated

not stated

not stated

not stated

Kronborg 1980

Glucagon

Placebo

not stated

not stated

not stated

not stated

MRC Multicentre Trial 1977

Glucagon

Placebo

not stated

not stated

not stated

not stated

Hansky 1969

Iniprol

No active intervention

not stated

not stated

not stated

not stated

Johnson 2001

Lexipafant

Placebo

not stated

not stated

not stated

not stated

Kingsnorth 1995

Lexipafant

Placebo

not stated

not stated

not stated

not stated

McKay 1997b

Lexipafant

Placebo

not stated

not stated

not stated

not stated

Bredkjaer 1988

NSAID

Placebo

not stated

not stated

not stated

not stated

Ebbehøj 1985

NSAID

Placebo

not stated

not stated

not stated

not stated

McKay 1997b

Octreotide

Placebo

not stated

not stated

not stated

not stated

Ohair 1993

Octreotide

Placebo

not stated

not stated

not stated

not stated

Paran 1995

Octreotide

No active intervention

not stated

not stated

not stated

not stated

Uhl 1999

Octreotide

Placebo

not stated

not stated

not stated

not stated

Wang 2013c (mild pancreatitis)

Octreotide

No active intervention

no

not stated

not stated

not stated

Wang 2013c (severe pancreatitis)

Octreotide

No active intervention

yes

not stated

not stated

not stated

Yang 2012

Octreotide

No active intervention

no

not stated

not stated

not stated

Besselink 2008

Probiotics

Placebo

not stated

not stated

not stated

not stated

Olah 2007

Probiotics

No active intervention

yes

not stated

not stated

not stated

Plaudis 2010

Probiotics

No active intervention

yes

not stated

not stated

not stated

Sharma 2011

Probiotics

Placebo

not stated

not stated

not stated

not stated

Zhu 2014

Probiotics

Placebo

yes

not stated

not stated

not stated

Choi 1989

Somatostatin

No active intervention

not stated

not stated

not stated

not stated

Gjørup 1992

Somatostatin

Placebo

not stated

not stated

not stated

not stated

Grupo Español 1996

Somatostatin

Placebo

yes

not stated

not stated

not stated

Luengo 1994

Somatostatin

No active intervention

not stated

not stated

not stated

not stated

Moreau 1986

Somatostatin

Placebo

not stated

not stated

not stated

not stated

Usadel 1985

Somatostatin

Placebo

not stated

not stated

not stated

not stated

Wang 2013a

Somatostatin

No active intervention

yes

not stated

not stated

not stated

Yang 1999

Somatostatin

No active intervention

not stated

not stated

not stated

not stated

Xia 2014

Somatostatin plus omeprazole

No active intervention

yes

not stated

not stated

not stated

Wang 2013a

Somatostatin plus ulinastatin

No active intervention

yes

not stated

not stated

not stated

Wang 2011

Thymosin

Placebo

yes

not stated

not stated

not stated

Abraham 2013 (mild pancreatitis)

Ulinastatin

Placebo

no

not stated

not stated

no

Abraham 2013 (severe pancreatitis)

Ulinastatin

Placebo

yes

not stated

not stated

not stated

Frulloni 1994

Gabexate

Aprotinin

not stated

yes

not stated

not stated

Pederzoli 1993b

Gabexate

Aprotinin

not stated

not stated

not stated

not stated

Kirsch 1978

Glucagon

Atropine

not stated

not stated

not stated

not stated

Chen 2002a

Ulinastatin

Gabexate

no

no

no

not stated

MRC Multicentre Trial 1977

Aprotinin

Glucagon

not stated

not stated

not stated

not stated

Guo 2015

Octerotide plus ulinastatin

Octreotide

yes

not stated

not stated

not stated

Wang 2013b

Octreotide plus NSAID

Octreotide

not stated

not stated

not stated

not stated

Chen 2002b

Ulinastatin

Octreotide

yes

yes

not stated

not stated

Gilsanz 1978

Glucagon

Oxyphenonium

not stated

not stated

not stated

not stated

Poropat 2015

Antibiotics

No active intervention

not stated

not stated

not stated

no

Wang 2016

Somatostatin plus gabexate

Somatostatin

yes

not stated

not stated

not stated

Wang 2013a

Somatostatin plus ulinastatin

Somatostatin

yes

not stated

not stated

not stated

Wang 2016

Somatostatin plus ulinastatin

Somatostatin

yes

not stated

not stated

not stated

Wang 2016

Somatostatin plus ulinastatin plus gabexate

Somatostatin

yes

not stated

not stated

not stated

Wang 2016

Somatostatin plus ulinastatin

Somatostatin plus gabexate

yes

not stated

not stated

not stated

Wang 2016

Somatostatin plus ulinastatin plus gabexate

Somatostatin plus gabexate

yes

not stated

not stated

not stated

Wang 2016

Somatostatin plus ulinastatin plus gabexate

Somatostatin plus ulinastatin

yes

not stated

not stated

not stated
Figuras y tablas -
Table 2. Potential effect modifiers (ordered by comparisons)
Ir a la tabla de la revisión
Table 3. Length of hospital stay (days)

Study name

Intervention

Comparator

Number of participants in intervention

Number of participants in control

Mean or median (standard deviation or interquartile range, if reported) hospital stay in intervention group

Mean or median (standard deviation or interquartile range, if reported) hospital stay in control group

Difference

Statistical significance (P‐value if reported)

Barreda 2009

Antibiotics

No active intervention

24

34

54

45

9

Not significant

Delcenserie 1996

Antibiotics

No active intervention

11

12

27.8

22

5.8

Not significant

Finch 1976

Antibiotics

No active intervention

31

27

10.4

11.3

−0.9

Not significant

Garcia‐Barrasa 2009

Antibiotics

Placebo

22

19

21

19

2

Not significant (0.80)

Hejtmankova 2003

Antibiotics

No active intervention

20

21

18 (7.2)

25 (14.8)

−7

Not significant

Isenmann 2004

Antibiotics

Placebo

58

56

21

18

3

Not significant

Luiten 1995

Antibiotics

No active intervention

50

52

30

32

−2

Not significant

Rokke 2007

Antibiotics

No active intervention

36

37

18

22

−4

Not significant (0.32)

Sainio 1995

Antibiotics

No active intervention

30

30

33.2 (22.1)

43.8 (43.1)

−10.6

Not significant (0.24)

Spicak 2002

Antibiotics

No active intervention

33

30

18.9 (8.1)

23.8 (19.3)

−4.9

Not significant

Spicak 2003

Antibiotics

No active intervention

20

21

18 (7.2)

25 (14.8)

−7

Not significant

Xue 2009

Antibiotics

No active intervention

29

27

28.3

30.7

−2.4

Not significant

Bansal 2011

Antioxidants

No active intervention

19

20

12.8

15.1

−2.3

Not significant

Sateesh 2009

Antioxidants

No active intervention

23

30

7.2 (5)

10.3 (7)

−3.1

Not significant (0.07)

Siriwardena 2007

Antioxidants

Placebo

22

21

20.4 (24.4)

14.3 (15.7)

6.1

Not significant (0.34)

Vege 2015

Antioxidants

Placebo

14

14

3

5

−2

Not significant (0.06)

Balldin 1983

Aprotinin

No active intervention

26

29

17.3

16.5

0.8

Not significant

Berling 1994

Aprotinin

No active intervention

22

26

25 (15‐32)

33 (17‐38)

−8

Not significant (0.24)

Goebell 1979

Calcitonin

Placebo

50

44

18.3 (6.4)

20.2 (7.5)

−1.9

Not significant

Martinez 1984

Calcitonin

Placebo

14

17

24 (20.2)

30 (21.7)

−6

Not significant

Buchler 1993

Gabexate

Placebo

115

108

26 (20‐43)

23 (28‐34)

3

Not significant

Debas 1980

Glucagon

Placebo

33

33

26 (28.7)

20 (19.2)

6

Not significant

Dürr 1978

Glucagon

Placebo

33

36

32.6

26.9

5.7

Not significant

Hansky 1969

Iniprol

No active intervention

15

9

14.7 (9.3)

18.7 (10.2)

−4

Not significant

Johnson 2001

Lexipafant

Placebo

151

139

9

10

−1

Not significant

McKay 1997b

Lexipafant

Placebo

26

24

13.3

14.9

−1.6

Not significant

Bredkjaer 1988

NSAID

Placebo

27

30

9

10

−1

Not significant

Ebbehøj 1985

NSAID

Placebo

14

16

13

15

−2

Not significant

McKay 1997a

Octreotide

Placebo

28

30

10

10

0

Not significant

Ohair 1993

Octreotide

Placebo

90

90

7.3

8.2

−0.9

Not significant

Paran 1995

Octreotide

No active intervention

19

19

17.9 (13.2)

34.1 (22.7)

−16.2

Significant (0.02)

Uhl 1999

Octreotide

Placebo

199

103

21.5

21

0.5

Not significant

Wang 2013c

(mild acute pancreatitis)

Octreotide

No active intervention

157

79

14.4

15.37

−0.97

Not significant

Wang 2013c

(severe acute pancreatitis)

Octreotide

No active intervention

91

45

16

16

0

Not significant

Yang 2012

Octreotide

No active intervention

80

77

7.4 (2)

11.8 (4)

−4.4

Significant

Besselink 2008

Probiotics

Placebo

152

144

28.9 (41.5)

23.5 (25.9)

5.4

Not significant (0.98)

Olah 2007

Probiotics

No active intervention

33

29

14.9

19.7

−4.8

Not significant

Sharma 2011

Probiotics

Placebo

24

26

13.23 (18.19)

9.69 (9.69)

3.54

Not significant (0.76)

Pettila 2010

Activated protein C

Placebo

16

16

17.1

34.4

−17.3

Significant (P < 0.05)

Gjørup 1992

Somatostatin

Placebo

33

30

12

10

2

Not significant

Luengo 1994

Somatostatin

No active intervention

50

50

14.92 (11.46)

20.28 (15)

−5.36

Significant

Wang 2011

Thymosin

Placebo

12

12

37.1 (22.7)

60.6 (32.9)

−23.5

Not significant (0.06)

Abraham 2013

(mild acute pancreatitis)

Ulinastatin

Placebo

30

32

7 (5‐22)

8 (5‐15)

−1

Not significant (0.07)

Abraham 2013

(severe acute pancreatitis)

Ulinastatin

Placebo

35

32

9 (6‐22)

10 (6‐22)

−1

Not significant (0.21)

Guo 2015

Octerotide plus ulinastatin

Octreotide

60

60

11.8 (3.9)

23.7 (16.3)

−11.9

Significant

Wang 2016

Somatostatin plus ulinastatin plus gabexate

Somatostatin

116

122

17.7 (32.1)

31.3 (37.6)

‐13.6

Significant

Wang 2016

Somatostatin plus ulinastatin

Somatostatin

124

122

22.6 (34.5)

31.3 (37.6)

‐8.7

Significant

Wang 2016

Somatostatin plus gabexate

Somatostatin

130

122

23.2 (29.6)

31.3 (37.6)

‐8.1

Significant

Wang 2016

Somatostatin plus ulinastatin plus gabexate

Somatostatin plus gabexate

116

130

17.7 (32.1)

23.2 (29.6)

−5.5

Significant

Wang 2016

Somatostatin plus ulinastatin

Somatostatin plus gabexate

124

130

22.6 (34.5)

23.2 (29.6)

−0.6

Significant

Wang 2016

Somatostatin plus ulinastatin plus gabexate

Somatostatin plus ulinastatin

116

124

17.7 (32.1)

22.6 (34.5)

−4.9

Significant

NSAID: non‐steroidal anti‐inflammatory drug.

Figuras y tablas -
Table 3. Length of hospital stay (days)
Ir a la tabla de la revisión
Table 4. Length of intensive care unit (ICU) stay (days)

Study name

Intervention

Control

Number of participants in intervention

Number of participants in control

Mean or median (standard deviation or interquartile range, if reported) intensive care stay in intervention group

Mean or median (standard deviation or interquartile range, if reported) intensive care stay in control group

Difference

Statistical significance (P‐value, reported)

Garcia‐Barrasa 2009

Antibiotics

Placebo

22

19

17

18

‐1

Not significant (P‐value = 0.83)

Isenmann 2004

Antibiotics

Placebo

58

56

8

6

2

Not significant

Nordback 2001

Antibiotics

Placebo

25

33

8

8

0

Not significant

Rokke 2007

Antibiotics

No active intervention

36

37

8

7

1

Not significant (P‐value = 0.78)

Sainio 1995

Antibiotics

No active intervention

30

30

12.7 (10.7)

23.6 (28.7)

‐10.9

Not significant (P‐value = 0.06)

Spicak 2002

Antibiotics

No active intervention

33

30

11.4 (5.4)

15.9 (12)

‐4.5

Not significant

Siriwardena 2007

Antioxidants

Placebo

22

21

4 (10.3)

0 (0)

4

Not significant (P‐value = 0.08)

Vege 2015

Antioxidants

Placebo

14

14

0

0

0

Significant (P‐value = 0.03)

Berling 1994

Aprotinin

No active intervention

22

26

9.5 (4 ‐ 10)

12 (3‐20)

‐2.5

Not significant (P‐value = 0.47)

Johnson 2001

Lexipafant

Placebo

151

139

9.5

11

‐1.5

Not significant

Besselink 2008

Probiotics

Placebo

152

144

6.6 (17.1)

3 (9.3)

3.6

Not significant (P‐value = 0.08)

Sharma 2011

Probiotics

Placebo

24

26

4.94 (9.54)

4 (5.86)

0.94

Not significant (P‐value = 0.94)

Wang 2011

Thymosin

Placebo

12

12

24.6 (19.6)

50.5 (25.7)

‐25.9

Significant (P‐value = 0.01)
Figuras y tablas -
Table 4. Length of intensive care unit (ICU) stay (days)
Ir a la tabla de la revisión
Comparison 1. Acute pancreatitis

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Short‐term mortality Show forest plot

67

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

1.1 Antibiotics versus control

17

1058

Odds Ratio (M‐H, Fixed, 95% CI)

0.81 [0.57, 1.15]

1.2 Antioxidants versus control

4

163

Odds Ratio (M‐H, Fixed, 95% CI)

2.01 [0.53, 7.56]

1.3 Aprotinin versus control

7

651

Odds Ratio (M‐H, Fixed, 95% CI)

0.68 [0.40, 1.14]

1.4 Calcitonin versus control

2

125

Odds Ratio (M‐H, Fixed, 95% CI)

0.55 [0.15, 2.00]

1.5 Cimetidine versus control

1

40

Odds Ratio (M‐H, Fixed, 95% CI)

1.0 [0.06, 17.18]

1.6 EDTA versus control

1

64

Odds Ratio (M‐H, Fixed, 95% CI)

0.94 [0.12, 7.08]

1.7 Gabexate versus control

5

576

Odds Ratio (M‐H, Fixed, 95% CI)

0.79 [0.48, 1.30]

1.8 Glucagon versus control

5

409

Odds Ratio (M‐H, Fixed, 95% CI)

0.97 [0.51, 1.87]

1.9 Iniprol versus control

1

24

Odds Ratio (M‐H, Fixed, 95% CI)

0.14 [0.01, 1.67]

1.10 Lexipafant versus control

3

423

Odds Ratio (M‐H, Fixed, 95% CI)

0.55 [0.30, 1.01]

1.11 Octreotide versus control

5

927

Odds Ratio (M‐H, Fixed, 95% CI)

0.76 [0.47, 1.23]

1.12 Probiotics versus control

2

358

Odds Ratio (M‐H, Fixed, 95% CI)

1.70 [0.87, 3.30]

1.13 Activated protein C versus control

1

32

Odds Ratio (M‐H, Fixed, 95% CI)

8.56 [0.41, 180.52]

1.14 Somatostatin versus control

6

493

Odds Ratio (M‐H, Fixed, 95% CI)

0.57 [0.29, 1.10]

1.15 Somatostatin plus omeprazole versus control

1

140

Odds Ratio (M‐H, Fixed, 95% CI)

0.23 [0.05, 1.11]

1.16 Somatostatin plus ulinastatin versus control

1

122

Odds Ratio (M‐H, Fixed, 95% CI)

0.43 [0.15, 1.23]

1.17 Thymosin versus control

1

24

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

1.18 Ulinastatin versus control

1

132

Odds Ratio (M‐H, Fixed, 95% CI)

0.45 [0.12, 1.72]

1.19 Gabexate versus aprotinin

2

298

Odds Ratio (M‐H, Fixed, 95% CI)

0.62 [0.32, 1.20]

1.20 Glucagon versus aprotinin

1

134

Odds Ratio (M‐H, Fixed, 95% CI)

1.33 [0.44, 4.08]

1.21 Glucagon versus atropine

1

150

Odds Ratio (M‐H, Fixed, 95% CI)

4.17 [0.45, 38.21]

1.22 Octreotide plus ulinastatin versus octreotide

1

120

Odds Ratio (M‐H, Fixed, 95% CI)

0.31 [0.06, 1.60]

1.23 Somatostatin plus gabexate versus somatostatin

1

252

Odds Ratio (M‐H, Fixed, 95% CI)

0.93 [0.37, 2.33]

1.24 Somatostatin plus ulinastatin versus somatostatin

2

369

Odds Ratio (M‐H, Fixed, 95% CI)

0.73 [0.34, 1.56]

1.25 Somatostatin plus ulinastatin plus gabexate versus somatostatin

1

238

Odds Ratio (M‐H, Fixed, 95% CI)

0.61 [0.21, 1.74]

1.26 Somatostatin plus ulinastatin versus somatostatin plus gabexate

1

254

Odds Ratio (M‐H, Fixed, 95% CI)

0.72 [0.26, 1.95]

1.27 Somatostatin plus ulinastatin plus gabexate versus somatostatin plus gabexate

1

246

Odds Ratio (M‐H, Fixed, 95% CI)

0.65 [0.23, 1.86]

1.28 Somatostatin plus ulinastatin plus gabexate versus somatostatin plus ulinastatin

1

240

Odds Ratio (M‐H, Fixed, 95% CI)

0.91 [0.30, 2.80]

2 Serious adverse events (proportion) Show forest plot

17

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

2.1 Antibiotics versus control

5

304

Odds Ratio (M‐H, Fixed, 95% CI)

0.65 [0.37, 1.15]

2.2 Antioxidants versus control

2

82

Odds Ratio (M‐H, Fixed, 95% CI)

1.98 [0.48, 8.13]

2.3 EDTA versus control

1

64

Odds Ratio (M‐H, Fixed, 95% CI)

0.52 [0.11, 2.39]

2.4 Gabexate versus control

2

201

Odds Ratio (M‐H, Fixed, 95% CI)

1.31 [0.31, 5.60]

2.5 Glucagon versus control

2

127

Odds Ratio (M‐H, Fixed, 95% CI)

0.29 [0.01, 7.46]

2.6 Octreotide versus control

1

58

Odds Ratio (M‐H, Fixed, 95% CI)

1.73 [0.61, 4.93]

2.7 Somatostatin versus control

2

111

Odds Ratio (M‐H, Fixed, 95% CI)

1.07 [0.35, 3.27]

2.8 Gabexate versus aprotinin

1

116

Odds Ratio (M‐H, Fixed, 95% CI)

1.05 [0.22, 4.91]

2.9 Ulinastatin versus gabexate

1

62

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

3 Serious adverse events (number) Show forest plot

37

Rate Ratio (Fixed, 95% CI)

Subtotals only

3.1 Antibiotics versus control

12

716

Rate Ratio (Fixed, 95% CI)

0.86 [0.68, 1.07]

3.2 Antioxidants versus control

2

71

Rate Ratio (Fixed, 95% CI)

0.22 [0.02, 2.21]

3.3 Aprotinin versus control

3

264

Rate Ratio (Fixed, 95% CI)

0.79 [0.49, 1.29]

3.4 Cimetidine versus control

1

60

Rate Ratio (Fixed, 95% CI)

1.0 [0.20, 4.95]

3.5 EDTA versus control

1

64

Rate Ratio (Fixed, 95% CI)

0.94 [0.19, 4.65]

3.6 Gabexate versus control

3

375

Rate Ratio (Fixed, 95% CI)

0.86 [0.64, 1.15]

3.7 Glucagon versus control

1

68

Rate Ratio (Fixed, 95% CI)

1.0 [0.02, 50.40]

3.8 Lexipafant versus control

1

290

Rate Ratio (Fixed, 95% CI)

0.67 [0.46, 0.96]

3.9 Octreotide versus control

4

770

Rate Ratio (Fixed, 95% CI)

0.74 [0.60, 0.89]

3.10 Probiotics versus control

3

397

Rate Ratio (Fixed, 95% CI)

0.94 [0.65, 1.36]

3.11 Somatostatin versus control

3

257

Rate Ratio (Fixed, 95% CI)

1.03 [0.66, 1.59]

3.12 Somatostatin plus omeprazole versus control

1

140

Rate Ratio (Fixed, 95% CI)

0.36 [0.19, 0.70]

3.13 Somatostatin plus ulinastatin versus control

1

122

Rate Ratio (Fixed, 95% CI)

0.30 [0.15, 0.60]

3.14 Glucagon versus atropine

1

150

Rate Ratio (Fixed, 95% CI)

0.33 [0.03, 3.20]

3.15 Octreotide plus ulinastatin versus octreotide

1

120

Rate Ratio (Fixed, 95% CI)

0.30 [0.17, 0.51]

3.16 Somatostatin plus ulinastatin versus somatostatin

1

123

Rate Ratio (Fixed, 95% CI)

0.28 [0.15, 0.56]

4 Organ failure Show forest plot

18

Odds Ratio (M‐H, Random, 95% CI)

Subtotals only

4.1 Antibiotics versus control

5

258

Odds Ratio (M‐H, Random, 95% CI)

0.78 [0.44, 1.38]

4.2 Antioxidants versus control

4

163

Odds Ratio (M‐H, Random, 95% CI)

0.92 [0.39, 2.12]

4.3 Gabexate versus control

1

50

Odds Ratio (M‐H, Random, 95% CI)

0.32 [0.01, 8.25]

4.4 Lexipafant versus control

2

340

Odds Ratio (M‐H, Random, 95% CI)

0.68 [0.36, 1.27]

4.5 Octreotide versus control

2

430

Odds Ratio (M‐H, Random, 95% CI)

0.51 [0.27, 0.97]

4.6 Probiotics versus control

2

358

Odds Ratio (M‐H, Random, 95% CI)

0.80 [0.26, 2.47]

4.7 Ulinastatin versus control

1

129

Odds Ratio (M‐H, Random, 95% CI)

0.27 [0.01, 6.67]

4.8 Somatostatin plus gabexate versus somatostatin

1

252

Odds Ratio (M‐H, Random, 95% CI)

0.78 [0.33, 1.80]

4.9 Somatostatin plus ulinastatin versus somatostatin

1

246

Odds Ratio (M‐H, Random, 95% CI)

0.58 [0.23, 1.45]

4.10 Somatostatin plus ulinastatin plus gabexate versus somatostatin

1

238

Odds Ratio (M‐H, Random, 95% CI)

0.46 [0.17, 1.25]

4.11 Somatostatin plus ulinastatin versus somatostatin plus gabexate

1

254

Odds Ratio (M‐H, Random, 95% CI)

0.75 [0.29, 1.92]

4.12 Somatostatin plus ulinastatin plus gabexate versus somatostatin plus gabexate

1

246

Odds Ratio (M‐H, Random, 95% CI)

0.59 [0.21, 1.65]

4.13 Somatostatin plus ulinastatin plus gabexate versus somatostatin plus ulinastatin

1

240

Odds Ratio (M‐H, Random, 95% CI)

0.79 [0.27, 2.35]

5 Infected pancreatic necrosis Show forest plot

15

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

5.1 Antibiotics versus control

11

714

Odds Ratio (M‐H, Fixed, 95% CI)

0.82 [0.53, 1.25]

5.2 Octreotide versus control

1

58

Odds Ratio (M‐H, Fixed, 95% CI)

0.52 [0.04, 6.06]

5.3 Probiotics versus control

3

397

Odds Ratio (M‐H, Fixed, 95% CI)

1.10 [0.62, 1.96]

6 Sepsis Show forest plot

11

Odds Ratio (M‐H, Random, 95% CI)

Subtotals only

6.1 Antibiotics versus control

1

60

Odds Ratio (M‐H, Random, 95% CI)

0.42 [0.11, 1.60]

6.2 Aprotinin versus control

2

103

Odds Ratio (M‐H, Random, 95% CI)

1.84 [0.49, 6.96]

6.3 Gabexate versus control

3

373

Odds Ratio (M‐H, Random, 95% CI)

1.10 [0.55, 2.19]

6.4 Lexipafant versus control

1

290

Odds Ratio (M‐H, Random, 95% CI)

0.26 [0.08, 0.83]

6.5 Octreotide versus control

2

340

Odds Ratio (M‐H, Random, 95% CI)

0.40 [0.05, 3.53]

6.6 Probiotics versus control

1

62

Odds Ratio (M‐H, Random, 95% CI)

0.36 [0.10, 1.36]

6.7 Gabexate versus aprotinin

1

116

Odds Ratio (M‐H, Random, 95% CI)

1.05 [0.22, 4.91]

7 Adverse events (proportion) Show forest plot

27

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

7.1 Antibiotics versus control

6

429

Odds Ratio (M‐H, Fixed, 95% CI)

0.51 [0.32, 0.80]

7.2 Antioxidants versus control

1

39

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

7.3 Calcitonin versus control

1

94

Odds Ratio (M‐H, Fixed, 95% CI)

0.88 [0.12, 6.49]

7.4 EDTA versus control

1

64

Odds Ratio (M‐H, Fixed, 95% CI)

0.79 [0.27, 2.31]

7.5 Gabexate versus control

3

373

Odds Ratio (M‐H, Fixed, 95% CI)

0.83 [0.54, 1.27]

7.6 Glucagon versus control

2

127

Odds Ratio (M‐H, Fixed, 95% CI)

0.09 [0.00, 1.69]

7.7 Lexipafant versus control

1

83

Odds Ratio (M‐H, Fixed, 95% CI)

0.43 [0.16, 1.12]

7.8 Octreotide versus control

3

398

Odds Ratio (M‐H, Fixed, 95% CI)

1.00 [0.65, 1.55]

7.9 Probiotics versus control

1

62

Odds Ratio (M‐H, Fixed, 95% CI)

0.35 [0.12, 1.01]

7.10 Somatostatin versus control

2

111

Odds Ratio (M‐H, Fixed, 95% CI)

0.44 [0.19, 1.02]

7.11 Somatostatin plus omeprazole versus control

1

140

Odds Ratio (M‐H, Fixed, 95% CI)

0.00 [0.00, 0.04]

7.12 Gabexate versus aprotinin

2

298

Odds Ratio (M‐H, Fixed, 95% CI)

0.41 [0.23, 0.70]

7.13 Ulinastatin versus gabexate

1

62

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

7.14 Ulinastatin versus octreotide

1

25

Odds Ratio (M‐H, Fixed, 95% CI)

2.33 [0.46, 11.81]

7.15 Somatostatin plus gabexate versus somatostatin

1

252

Odds Ratio (M‐H, Fixed, 95% CI)

0.93 [0.44, 1.95]

7.16 Somatostatin plus ulinastatin versus somatostatin

1

246

Odds Ratio (M‐H, Fixed, 95% CI)

0.58 [0.25, 1.34]

7.17 Somatostatin plus ulinastatin plus gabexate versus somatostatin

1

238

Odds Ratio (M‐H, Fixed, 95% CI)

0.49 [0.20, 1.20]

7.18 Somatostatin plus ulinastatin versus somatostatin plus gabexate

1

254

Odds Ratio (M‐H, Fixed, 95% CI)

0.63 [0.27, 1.44]

7.19 Somatostatin plus ulinastatin plus gabexate versus somatostatin plus gabexate

1

246

Odds Ratio (M‐H, Fixed, 95% CI)

0.53 [0.22, 1.28]

7.20 Somatostatin plus ulinastatin plus gabexate versus somatostatin plus ulinastatin

1

240

Odds Ratio (M‐H, Fixed, 95% CI)

0.84 [0.32, 2.22]

8 Adverse events (number) Show forest plot

40

Rate Ratio (Random, 95% CI)

Subtotals only

8.1 Antibiotics versus control

12

755

Rate Ratio (Random, 95% CI)

0.75 [0.58, 0.95]

8.2 Antioxidants versus control

2

94

Rate Ratio (Random, 95% CI)

0.82 [0.38, 1.79]

8.3 Aprotinin versus control

3

264

Rate Ratio (Random, 95% CI)

0.98 [0.69, 1.39]

8.4 Calcitonin versus control

1

94

Rate Ratio (Random, 95% CI)

0.88 [0.12, 6.25]

8.5 Cimetidine versus control

1

60

Rate Ratio (Random, 95% CI)

1.14 [0.64, 2.02]

8.6 EDTA versus control

1

64

Rate Ratio (Random, 95% CI)

0.63 [0.28, 1.39]

8.7 Gabexate versus control

3

375

Rate Ratio (Random, 95% CI)

0.76 [0.61, 0.95]

8.8 Glucagon versus control

2

90

Rate Ratio (Random, 95% CI)

1.19 [0.51, 2.80]

8.9 Lexipafant versus control

1

290

Rate Ratio (Random, 95% CI)

0.61 [0.44, 0.85]

8.10 Octreotide versus control

4

634

Rate Ratio (Random, 95% CI)

0.78 [0.58, 1.05]

8.11 Probiotics versus control

3

397

Rate Ratio (Random, 95% CI)

0.84 [0.52, 1.36]

8.12 Somatostatin versus control

2

134

Rate Ratio (Random, 95% CI)

0.75 [0.26, 2.18]

8.13 Ulinastatin versus control

1

129

Rate Ratio (Random, 95% CI)

0.69 [0.32, 1.46]

8.14 Gabexate versus aprotinin

1

182

Rate Ratio (Random, 95% CI)

0.66 [0.38, 1.14]

8.15 Glucagon versus atropine

1

150

Rate Ratio (Random, 95% CI)

0.79 [0.36, 1.73]

8.16 Oxyphenonium versus glucagon

1

62

Rate Ratio (Random, 95% CI)

0.93 [0.65, 1.34]

8.17 Octreotide plus ulinastatin versus octreotide

1

120

Rate Ratio (Random, 95% CI)

0.29 [0.17, 0.48]

9 Requirement for additional invasive intervention Show forest plot

32

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

9.1 Antibiotics versus control

14

884

Odds Ratio (M‐H, Fixed, 95% CI)

0.82 [0.59, 1.13]

9.2 Aprotinin versus control

2

237

Odds Ratio (M‐H, Fixed, 95% CI)

0.59 [0.23, 1.47]

9.3 Calcitonin versus control

2

125

Odds Ratio (M‐H, Fixed, 95% CI)

0.30 [0.08, 1.16]

9.4 Cimetidine versus control

1

60

Odds Ratio (M‐H, Fixed, 95% CI)

0.13 [0.01, 2.61]

9.5 EDTA versus control

1

64

Odds Ratio (M‐H, Fixed, 95% CI)

0.68 [0.14, 3.29]

9.6 Gabexate versus control

3

426

Odds Ratio (M‐H, Fixed, 95% CI)

0.58 [0.37, 0.90]

9.7 Glucagon versus control

2

260

Odds Ratio (M‐H, Fixed, 95% CI)

1.26 [0.58, 2.77]

9.8 Octreotide versus control

3

854

Odds Ratio (M‐H, Fixed, 95% CI)

0.76 [0.48, 1.21]

9.9 Probiotics versus control

2

358

Odds Ratio (M‐H, Fixed, 95% CI)

1.50 [0.83, 2.71]

9.10 Somatostatin versus control

1

100

Odds Ratio (M‐H, Fixed, 95% CI)

0.40 [0.11, 1.38]

9.11 Gabexate versus aprotinin

1

182

Odds Ratio (M‐H, Fixed, 95% CI)

0.5 [0.19, 1.32]

9.12 Glucagon versus aprotinin

1

134

Odds Ratio (M‐H, Fixed, 95% CI)

1.33 [0.44, 4.08]

9.13 Oxyphenonium versus glucagon

1

62

Odds Ratio (M‐H, Fixed, 95% CI)

1.0 [0.13, 7.59]

10 Endoscopic or radiological drainage of collections Show forest plot

3

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

10.1 Antibiotics versus control

1

23

Odds Ratio (M‐H, Fixed, 95% CI)

0.33 [0.01, 9.07]

10.2 Octreotide versus control

1

372

Odds Ratio (M‐H, Fixed, 95% CI)

0.89 [0.40, 1.96]

10.3 Probiotics versus control

1

39

Odds Ratio (M‐H, Fixed, 95% CI)

0.94 [0.20, 4.44]
Figuras y tablas -
Comparison 1. Acute pancreatitis
Ir a la tabla de la revisión
Comparison 2. Acute necrotising pancreatitis

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Short‐term mortality Show forest plot

11

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

1.1 Antibiotics versus control

10

683

Odds Ratio (M‐H, Fixed, 95% CI)

0.82 [0.52, 1.30]

1.2 Gabexate versus aprotinin

1

116

Odds Ratio (M‐H, Fixed, 95% CI)

0.52 [0.20, 1.36]

2 Serious adverse events (proportion) Show forest plot

5

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

2.1 Antibiotics versus control

4

281

Odds Ratio (M‐H, Fixed, 95% CI)

0.84 [0.46, 1.54]

2.2 Gabexate versus aprotinin

1

116

Odds Ratio (M‐H, Fixed, 95% CI)

1.05 [0.22, 4.91]

3 Serious adverse events (number) Show forest plot

7

Rate Ratio (Fixed, 95% CI)

Subtotals only

3.1 Antibiotics versus control

7

Rate Ratio (Fixed, 95% CI)

0.79 [0.59, 1.06]

4 Organ failure Show forest plot

4

Odds Ratio (M‐H, Random, 95% CI)

Subtotals only

4.1 Antibiotics versus control

4

211

Odds Ratio (M‐H, Random, 95% CI)

0.78 [0.42, 1.45]

5 Infected pancreatic necrosis Show forest plot

6

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

5.1 Antibiotics versus control

6

426

Odds Ratio (M‐H, Fixed, 95% CI)

0.85 [0.51, 1.42]

6 Sepsis Show forest plot

2

Odds Ratio (M‐H, Random, 95% CI)

Subtotals only

6.1 Antibiotics versus control

1

60

Odds Ratio (M‐H, Random, 95% CI)

0.42 [0.11, 1.60]

6.2 Gabexate versus aprotinin

1

116

Odds Ratio (M‐H, Random, 95% CI)

1.05 [0.22, 4.91]
Figuras y tablas -
Comparison 2. Acute necrotising pancreatitis
Ir a la tabla de la revisión
Comparison 3. Severe acute pancreatitis

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Short‐term mortality Show forest plot

22

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

1.1 Antibiotics versus control

9

542

Odds Ratio (M‐H, Fixed, 95% CI)

0.82 [0.53, 1.27]

1.2 Aprotinin versus control

2

103

Odds Ratio (M‐H, Fixed, 95% CI)

0.66 [0.19, 2.30]

1.3 Calcitonin versus control

1

31

Odds Ratio (M‐H, Fixed, 95% CI)

0.78 [0.11, 5.46]

1.4 Gabexate versus control

1

52

Odds Ratio (M‐H, Fixed, 95% CI)

0.19 [0.04, 0.99]

1.5 Probiotics versus control

1

62

Odds Ratio (M‐H, Fixed, 95% CI)

0.25 [0.05, 1.34]

1.6 Activated protein C versus control

1

32

Odds Ratio (M‐H, Fixed, 95% CI)

8.56 [0.41, 180.52]

1.7 Somatostatin versus control

2

182

Odds Ratio (M‐H, Fixed, 95% CI)

0.51 [0.21, 1.23]

1.8 Somatostatin plus omeprazole versus control

1

140

Odds Ratio (M‐H, Fixed, 95% CI)

0.23 [0.05, 1.11]

1.9 Somatostatin plus ulinastatin versus control

1

122

Odds Ratio (M‐H, Fixed, 95% CI)

0.43 [0.15, 1.23]

1.10 Thymosin versus control

1

24

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

1.11 Ulinastatin versus control

1

70

Odds Ratio (M‐H, Fixed, 95% CI)

0.24 [0.04, 1.29]

1.12 Octreotide plus ulinastatin versus octreotide

1

120

Odds Ratio (M‐H, Fixed, 95% CI)

0.31 [0.06, 1.60]

1.13 Somatostatin plus gabexate versus somatostatin

1

252

Odds Ratio (M‐H, Fixed, 95% CI)

0.93 [0.37, 2.33]

1.14 Somatostatin plus ulinastatin versus somatostatin

2

369

Odds Ratio (M‐H, Fixed, 95% CI)

0.73 [0.34, 1.56]

1.15 Somatostatin plus ulinastatin plus gabexate versus somatostatin

1

238

Odds Ratio (M‐H, Fixed, 95% CI)

0.61 [0.21, 1.74]

1.16 Somatostatin plus ulinastatin versus somatostatin plus gabexate

1

254

Odds Ratio (M‐H, Fixed, 95% CI)

0.72 [0.26, 1.95]

1.17 Somatostatin plus ulinastatin plus gabexate versus somatostatin plus gabexate

1

246

Odds Ratio (M‐H, Fixed, 95% CI)

0.65 [0.23, 1.86]

1.18 Somatostatin plus ulinastatin plus gabexate versus somatostatin plus ulinastatin

1

240

Odds Ratio (M‐H, Fixed, 95% CI)

0.91 [0.30, 2.80]

2 Serious adverse events (proportion) Show forest plot

3

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

2.1 Antibiotics versus control

3

164

Odds Ratio (M‐H, Fixed, 95% CI)

0.56 [0.27, 1.18]

3 Serious adverse events (number) Show forest plot

13

Rate Ratio (Random, 95% CI)

Subtotals only

3.1 Antibiotics versus control

5

Rate Ratio (Random, 95% CI)

0.81 [0.52, 1.25]

3.2 Aprotinin versus control

2

Rate Ratio (Random, 95% CI)

0.65 [0.25, 1.71]

3.3 Gabexate versus control

1

Rate Ratio (Random, 95% CI)

0.64 [0.37, 1.10]

3.4 Probiotics versus control

2

Rate Ratio (Random, 95% CI)

0.62 [0.24, 1.59]

3.5 Somatostatin versus control

1

Rate Ratio (Random, 95% CI)

1.07 [0.67, 1.69]

3.6 Somatostatin plus omeprazole versus control

1

Rate Ratio (Random, 95% CI)

0.36 [0.19, 0.70]

3.7 Somatostatin plus ulinastatin versus control

1

Rate Ratio (Random, 95% CI)

0.30 [0.15, 0.60]

3.8 Octreotide plus ulinastatin versus octreotide

1

Rate Ratio (Random, 95% CI)

0.30 [0.17, 0.51]

3.9 Somatostatin plus ulinastatin versus somatostatin

1

Rate Ratio (Random, 95% CI)

0.28 [0.15, 0.56]

4 Organ failure Show forest plot

6

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

4.1 Antibiotics versus control

3

137

Odds Ratio (M‐H, Fixed, 95% CI)

0.89 [0.40, 1.99]

4.2 Lexipafant versus control

0

0

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

4.3 Probiotics versus control

1

62

Odds Ratio (M‐H, Fixed, 95% CI)

0.40 [0.12, 1.36]

4.4 Ulinastatin versus control

1

67

Odds Ratio (M‐H, Fixed, 95% CI)

0.05 [0.01, 0.21]

4.5 Somatostatin plus gabexate versus somatostatin

1

252

Odds Ratio (M‐H, Fixed, 95% CI)

0.78 [0.33, 1.80]

4.6 Somatostatin plus ulinastatin versus somatostatin

1

246

Odds Ratio (M‐H, Fixed, 95% CI)

0.58 [0.23, 1.45]

4.7 Somatostatin plus ulinastatin plus gabexate versus somatostatin

1

238

Odds Ratio (M‐H, Fixed, 95% CI)

0.46 [0.17, 1.25]

4.8 Somatostatin plus ulinastatin versus somatostatin plus gabexate

1

254

Odds Ratio (M‐H, Fixed, 95% CI)

0.75 [0.29, 1.92]

4.9 Somatostatin plus ulinastatin plus gabexate versus somatostatin plus gabexate

1

246

Odds Ratio (M‐H, Fixed, 95% CI)

0.59 [0.21, 1.65]

4.10 Somatostatin plus ulinastatin plus gabexate versus somatostatin plus ulinastatin

1

240

Odds Ratio (M‐H, Fixed, 95% CI)

0.79 [0.27, 2.35]

5 Infected pancreatic necrosis Show forest plot

8

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

5.1 Antibiotics versus control

6

341

Odds Ratio (M‐H, Fixed, 95% CI)

0.73 [0.41, 1.33]

5.2 Probiotics versus control

2

101

Odds Ratio (M‐H, Fixed, 95% CI)

0.60 [0.22, 1.68]

6 Sepsis Show forest plot

3

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

6.1 Aprotinin versus control

2

103

Odds Ratio (M‐H, Fixed, 95% CI)

1.87 [0.50, 6.98]

6.2 Probiotics versus control

1

62

Odds Ratio (M‐H, Fixed, 95% CI)

0.36 [0.10, 1.36]
Figuras y tablas -
Comparison 3. Severe acute pancreatitis
Ir a la tabla de la revisión