Effect of Precut Sphincterotomy on Post-endoscopic Retrograde Cholangiopancreatography Pancreatitis: a Systematic Review and Meta-analysis

Overview

Journal World J Gastroenterol

Publisher Baishideng Publishing Group

Specialty Gastroenterology

Date 2014 Apr 19

PMID 24744601

Citations 18

Authors

Abhishek Choudhary

Jessica Winn

Sameer Siddique

Murtaza Arif

Zainab Arif

Ghassan M Hammoud

Srinivas R Puli

Jamal A Ibdah

Matthew L Bechtold

Affiliations

Soon will be listed here.

Abstract

Aim: To conduct a systemic review and meta-analysis to investigate the role of early precut technique. Multiple randomized controlled trails (RCTs) have reported conflicting results of the early precut sphincterotomy.

Methods: MEDLINE/PubMed, EMBASE, Cochrane Central Register of Controlled Trials and Database of Systematic Reviews, and recent abstracts from major conference proceedings were searched (June 2013). Randomized and non-randomized studies comparing early precut technique with prolonged standard methods were included. Pooled estimates of post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP), cannulation and adverse events were analyzed by using odds ratio (OR). Random and fixed effects models were used as appropriate. Publication bias was assessed by funnel plots. Heterogeneity among studies was assessed by calculating I² measure of inconsistency.

Results: Seven randomized and seven non-randomized trials met inclusion criteria. Meta-analysis of RCTs showed a decrease trend for PEP with early precut sphincterotomy but was not statistically significant (OR = 0.58; 95%CI: 0.32-1.05; P = 0.07). No heterogeneity was noted among the studies with I² of 0%.

Conclusion: Early precut technique for common bile duct cannulation decreases the trend of post-ERCP pancreatitis.

Citing Articles

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Initial experience with a homemade "hybrid-tome" for needle-knife precut in patients with difficult biliary cannulation.

De la Morena Madrigal E, Rodriguez Garcia I, Galera Rodenas A, Perez Arellano E Endosc Int Open. 2021; 9(11):E1611-E1616.

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Difficult Biliary Cannulation in Endoscopic Retrograde Cholangiopancreatography: An Overview of Advanced Techniques.

Fung B, Pitea T, Tabibian J Eur Med J Hepatol. 2021; 9(1):73-82.

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Efficacy and safety of primary, early and late needle-knife fistulotomy for biliary access.

Canena J, Lopes L, Fernandes J, Alexandrino G, Figueiredo L, Moreira M Sci Rep. 2021; 11(1):16658.

PMID: 34404873 PMC: 8371017. DOI: 10.1038/s41598-021-96142-9.

Influence of a novel classification of the papilla of Vater on the outcome of needle-knife fistulotomy for biliary cannulation.

Canena J, Lopes L, Fernandes J, Costa P, Arvanitakis M, Koch A BMC Gastroenterol. 2021; 21(1):147.

PMID: 33794778 PMC: 8017832. DOI: 10.1186/s12876-021-01735-3.

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