Brief Article
Copyright ©2010 Baishideng. All rights reserved.
World J Gastroenterol. Aug 21, 2010; 16(31): 3970-3978
Published online Aug 21, 2010. doi: 10.3748/wjg.v16.i31.3970
Use of pre-, pro- and synbiotics in patients with acute pancreatitis: A meta-analysis
Ming-Ming Zhang, Jing-Qiu Cheng, Yan-Rong Lu, Zhi-Hui Yi, Ping Yang, Xiao-Ting Wu
Ming-Ming Zhang, Ping Yang, Xiao-Ting Wu, Gastroenterological Surgery Center, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
Jing-Qiu Cheng, Yan-Rong Lu, Key Laboratory of Transplantation Engineering and Immunology, the Ministry of Health, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
Zhi-Hui Yi, Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
Author contributions: Zhang MM and Wu XT designed the research; Zhang MM and Yi ZH performed the searches and collected data; Cheng JQ and Wu XT supervised the research; Zhang MM and Yang P analyzed data; Zhang MM and Lu YR wrote the paper.
Supported by The Grant for the Research Projects of Sichuan Province, China. No. 07FG002-032
Correspondence to: Xiao-Ting Wu, Professor, Gastroenterological Surgery Center, West China Hospital, Sichuan University, 37 Guo Xue Xiang, Chengdu 610041, Sichuan Province, China. mmzhangmd@163.com
Telephone: +86-28-85422876 Fax: +86-28-85422483
Received: April 14, 2010
Revised: May 25, 2010
Accepted: June 1, 2010
Published online: August 21, 2010
Abstract

AIM: 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.

CONCLUSION: 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.

Keywords: Probiotics; Synbiotics; Prebiotics; Nutrition support; Acute pancreatitis