Use of pre-, pro- and synbiotics in patients with acute pancreatitis: a meta-analysis.
OBJECTIVE
To assess the clinical outcomes of pre-, pro- and synbiotics therapy in patients with acute pancreatitis.


METHODS
The databases including Medline, Embase, the Cochrane Library, Web of Science and Chinese Biomedicine Database were searched for all relevant randomized controlled trials that studied the effects of pre-, pro- or synbiotics in patients with acute pancreatitis. Main outcome measures were postoperative infections, pancreatic infections, multiple organ failure (MOF), systemic inflammatory response syndrome (SIRS), length of hospital stay, antibiotic therapy and mortality.


RESULTS
Seven randomized studies with 559 acute pancreatic patients were included. Pre-, pro- or synbiotics treatment showed no influence on the incidence of postoperative infections [odds ratios (OR) 0.30, 95% confidence interval (CI): 0.09-1.02, P = 0.05], pancreatic infection (OR 0.50, 95% CI: 0.12-2.17, P = 0.36), MOF (OR 0.88, 95% CI: 0.35-2.21, P = 0.79) and SIRS (OR 0.78, 95% CI: 0.20-2.98, P = 0.71). There were also no significant differences in the length of antibiotic therapy (OR 0.75, 95% CI: 0.50 - 1.14, P = 0.18) and the mortality (OR 0.75, 95% CI: 0.25-2.24, P = 0.61). However, Pre-, pro- or synbiotics treatment was associated with a reduced length of hospital stay (OR -3.87, 95% CI: -6.20 to -1.54, P = 0.001). When stratifying for the severity of acute pancreatitis, the main results were similar.


CONCLUSIONS
Pre-, pro- or synbiotics treatment shows no significant influence on patients with acute pancreatitis. There is a lack of evidence to support the use of probiotics/synbiotics in this area.
Zhang
Ming-Ming
MM
Gastroenterological Surgery Center, West China Hospital, Sichuan University, 37 Guo Xue Xiang, Chengdu, Sichuan Province, China. mmzhangmd@163.com
Cheng
Jing-Qiu
JQ
Lu
Yan-Rong
YR
Yi
Zhi-Hui
ZH
Yang
Ping
P
Wu
Xiao-Ting
XT
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D018450:Disease Progression; D006801:Humans; D007902:Length of Stay; D016017:Odds Ratio; D010195:Pancreatitis / Q000382:microbiology / Q000401:mortality / Q000601:surgery / Q000628:therapy*; D019283:Pancreatitis, Acute Necrotizing / Q000382:microbiology / Q000401:mortality / Q000517:prevention & control*; D056692:Prebiotics; D019936:Probiotics / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D058616:Synbiotics; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D056692:Prebiotics