S3241 Statins for the Prevention of Post-ERCP Pancreatitis: A Systematic Review and Meta-Analysis

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The American Journal of Gastroenterology


INTRODUCTION: Acute pancreatitis is one of the most common complications after ERCP. There is no definite consensus on chemoprophylaxis for the prevention of post-ERCP pancreatitis (PEP). Recently, there has been interest in the role of statins in the prevention of PEP. Our study aims to perform a systematic review and meta-analysis on the use of statins for the prevention of PEP. METHODS: We performed a comprehensive literature search of Embase, Medline and SCOPUS using MeSH terms and keywords for statins, ERCP and pancreatitis from inception through June 2020. Two reviewers independently screened all results in two stages: title/abstract followed by full-text review. We included full articles as well as meeting abstracts in our search. Only studies with multivariate analysis were included. The primary outcome of interest was incidence of PEP. For the present analysis, adjusted odds ratio and 95% confidence intervals (CI) reported by individual studies were utilized. For pooled analysis, a random-effects model was used, and weights were assigned for each study based on the inverse of variance. Heterogeneity among studies was assessed using the Higgins I2 value. Publication bias was assessed visually with funnel plots. All P-values were two-tailed with statistical significance specified at 0.05 and CI reported at 95% level. RESULTS: 7 studies were included in the final analysis with a pooled sample size (n) of 8,873. Only 6 studies reported the proportion of patients in the statin and non-statin groups (2,479 in statin group; 5,744 in non-statin group). Out of the 7 studies, 2 were conference abstracts and 5 were full articles. The pooled adjusted Odds Ratio (OR) was 0.63 (95% CI 0.38-1.03), P-value 0.064 (Figure 1). There was significant heterogeneity with I2 of 76.4%. There is also publication bias on visual inspection of the funnel plot (Figure 2). CONCLUSION: The use of statins is not associated with a decrease in post-ERCP pancreatitis as per the results of our meta-analysis, albeit with significant heterogeneity of data. Given the ubiquity of statin use and favorable side effect profile, larger randomized studies are warranted before we make definitive conclusions.



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