Comparison on continuous regional arterial infusion and intravenous administration in the treatment of severe acute pancreatitis: A systematic review

OBJECTIVE: To assess the clinical effectiveness of continuous regional arterial infusion (CRAI) and intravenous administration in the treatment of severe acute pancreatitis (SAP). METHODS: The database such as PubMed, Cochrane Library, EMbase, CNKI, and CBM were searched to collect randomized controlled trials (RCTs) from the establishment to July 2012, and articles about CRAI and intravenous administration in the treatment of SAP were retrieved. Studies were screened, data were extracted, and the methodological quality was assessed. Meta-analyses were conducted by using RevMan 5.0 software. RESULTS: A total of 10 RCTs involving 597 patients were included. Results of Meta-analysis showed that CRAI was better than intravenous administration in the cure rates (OR=3.42, 95%CI[2.14, 5. 45], P<0.00001), the rates of surgical intervention (OR=0.39, 95%CI[0.23, 0.64], P=0.0002), the secondary infection rates (OR=0.24, 95%CI[0.14, 0.42], P<0.00001) and the complications morbidity rates (OR=0.28, 95%CI[0.13, 0.59], P=0.0009). CONCLUSION: There are differences in the modes of administration between CARI and intravenous administration. CARI is superior to intravenous administration in the aspects of cure rate, rate of surgical intervention, secondary infection rates and complications and morbidity rates.