Systematic Reviews
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jun 7, 2015; 21(21): 6745-6753
Published online Jun 7, 2015. doi: 10.3748/wjg.v21.i21.6745
Antioxidant drugs to prevent post-endoscopic retrograde cholangiopancreatography pancreatitis: What does evidence suggest?
Clotilde Fuentes-Orozco, Carlos Dávalos-Cobián, Jesús García-Correa, Gabriela Ambriz-González, Michel Dassaejv Macías-Amezcua, Jesús García-Rentería, Jorge Rendón-Félix, Mariana Chávez-Tostado, Lizbeth Araceli Cuesta-Márquez, Andrea Socorro Alvarez-Villaseñor, Ana Olivia Cortés-Flores, Alejandro González-Ojeda
Clotilde Fuentes-Orozco, Michel Dassaejv Macías-Amezcua, Jesús García-Rentería, Jorge Rendón-Félix, Mariana Chávez-Tostado, Lizbeth Araceli Cuesta-Márquez, Ana Olivia Cortés-Flores, Alejandro González-Ojeda, Research Unit in Clinical Epidemiology, Specialties Hospital of the Western Medical Center, Medical Unit of High Specialty, Mexican Institute of Social Security, Guadalajara, Jalisco 44340, México
Carlos Dávalos-Cobián, Jesús García-Correa, Department Gastrointestinal Endoscopy, Specialties Hospital of the Western Medical Center, Medical Unit of High Specialty, Mexican Institute of Social Security, Guadalajara, Jalisco 44340, México
Gabriela Ambriz-González, Department of Pediatric Surgery. Children’s Hospital. Western National Medical Center, Mexican Institute of Social Security, Guadalajara, Jalisco 44340, México
Andrea Socorro Alvarez-Villaseñor, Health Research Coordination. Mexican Institute of Social Security, Baja Californa Sur 23000, Mexico
Author contributions: Fuentes-Orozco C, Ambriz-González G, Macías-Amezcua MD, García-Rentería J, Rendón-Félix J, Chávez-Tostado M, Cuesta-Márquez LA, Alvarez Villaseñor AS Cortés-Flores AO and González-Ojeda A participated in the protocol design, reviewed all manuscript changes included in the minireview article, analyzed the data, made critical reviews and wrote the final version of the manuscript; Dávalos-Cobián C, García-Correa J contributed with the data analysis, critical review of the results and writing of the final version of the manuscript.
Conflict-of-interest: The authors declare no conflict of interest.
Data sharing: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Alejandro González-Ojeda, MD, PhD, FACS, Research Unit in Clinical Epidemiology, Specialties Hospital of the Western Medical Center, Medical Unit of High Specialty, Mexican Institute of Social Security, Av. Belisario Domínguez 1000. Col. Independencia, Guadalajara, Jalisco 44340, México. avygail5@gmail.com
Telephone: +52-33-38485410 Fax: +52-33-38485413
Received: December 3, 2014
Peer-review started: December 5, 2014
First decision: January 22, 2015
Revised: January 30, 2015
Accepted: April 28, 2015
Article in press: April 28, 2015
Published online: June 7, 2015
Core Tip

Core tip: Acute pancreatitis is considered one of the most serious complications after endoscopic retrograde cholangiopancreatography (ERCP). The mechanism of post-ERCP pancreatitis remains unclear but several studies show that free radicals play a role in its pathogenesis. Antioxidant drugs have been tested using different routes of administration and dosifications. The analysis of all randomized clinical trials published since 1999 did not revealed any significant reduction in the incidence and severity of post-endoscopic retrograde cholangiopancreatography pancreatitis (PEP) when compared with placebo. There is currently a lack of robust trials to support the use of antioxidants for the prevention of PEP. Well-designed placebo-controlled randomized controlled trials are warranted to determine any beneficial effect.