Effects of Preoperative Proton Pump Inhibitor Administration on Bleeding After Gastric Endoscopic Submucosal Dissection: A Systematic Review and Meta-analysis

Overview

Journal United European Gastroenterol J

Publisher Wiley

Specialty Gastroenterology

Date 2016 Mar 12

PMID 26966517

Citations 10

Authors

Toshihiro Nishizawa

Hidekazu Suzuki

Teppei Akimoto

Tadateru Maehata

Toshio Morizane

Takanori Kanai

Naohisa Yahagi

Affiliations

Soon will be listed here.

Abstract

Background And Aim: The efficacy of using proton pump inhibitors (PPIs) prior to gastric endoscopic submucosal dissection (ESD) to reduce gastric bleeding remains controversial. This study aimed to systematically review the literature to evaluate the efficacy of preoperative PPI use to reduce post-ESD bleeding.

Methods: PubMed, the Cochrane library, and the Igaku-Chuo-Zasshi database were searched to identify randomized trials eligible for inclusion in the systematic review. Data from four studies (406 patients) were combined to calculate a pooled risk difference (RD) for developing post-ESD bleeding.

Results: Compared with patients who received no premedication, the pooled RD for post-ESD bleeding in patients who received preoperavive PPI was -0.027 (95% confidence interval: -0.070-0.017, p = 0.228), without significant heterogeneity. Preoperavive PPI use significantly increased gastric pH (weighted mean difference: 1.289, 95% CI: 0.227-2.352, p = 0.0174).

Conclusions: This systematic review and meta-analysis showed that premedication with PPI had no advantage for the prevention of post-ESD bleeding, despite increasing gastric pH.

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