Early precut sphincterotomy and the risk of endoscopic retrograde cholangiopancreatography related complications: An updated meta-analysis

Table 1 Study quality characteristics of randomized controlled trials

Ref.	Were patients randomized	Was generation of allocation sequence adequate	Eligibility criteria mentioned	Both patients and clinicians blinded	Participants baseline characteristics similar in both groups	Treatment allocation concealed	Study adequately powered to asses significant clinical outcome
Tang et al[10]	Yes	Yes	Yes	Partially fulfilled	Yes	Yes	No
Zhou et al[19]	Yes	Yes	Partially	Partially fulfilled	Yes	Yes	N/A
de Weerth et al[12]	Yes	N/A	Yes	Partially fulfilled	Yes	N/A	N/A
Khatibian et al[18]	Yes	Yes	Yes	Partially fulfilled	Yes	Yes	Partially
Manes et al[20]	Yes	Yes	Yes	Partially fulfilled	Yes	N/A	No
Cennamo et al[11]	Yes	Yes	Yes	Partially fulfilled	Yes	Yes	No
Swan et al[14]	Yes	Yes	Yes	Yes	Yes	Yes	No

Table 2 Study characteristics of randomized controlled trials

Ref.	Country	Center involved	No. of patients screened	Patients allocated to early precut/persistent attempts
Tang et al[10]	Canada	Single center	642	32/30
Zhou et al[19]	China	Single center	948	43/48
de Weerth et al[12]	Germany	Single center	291	145/146
Khatibian et al[18]	Iran	Single center	242	106/112
Manes et al[20]	Italy	Multicenter	1654	80/78
Cennamo et al[11]	Italy	Single center	1078	36/110
Swan et al[14]	Australia	Single center	464	39/34

Table 3 Techniques of pre-cut in randomized controlled trials

Ref.	Technique used in persistent attempts group	Timing of early precut	Precut technique	Timing of persistent attempts
Tang et al[10]	Non-wire guided sphincterotome	Biliary cannulation failed within 12 min	Needle knife precut starting at orifice	Biliary cannulation failed within 15 min
Zhou et al[19]	Non-wire guided and wire guided sphincterotome	Biliary cannulation failed within 10 min or 3 unintended pancreatic duct cannulation	Needle knife precut starting at orifice and fistulotomy	Not available
de Weerth et al[12]	Wire guided sphincterotome	Immediate precut for direct bile duct access	Erlangen type sphincterotome on the papillary roof	Biliary cannulation failed within 10 min or 3 unintended pancreatic duct cannulation
Khatibian et al[18]	Wire guided sphincterotome	Immediate needle knife fistulotomy for direct CBD access	Needle knife fistulotomy	Biliary cannulation failed within 15 min
Manes et al[20]	Non-wire guided and wire guided sphincterotome	Biliary cannulation failed within 10 min	Needle knife fistulotomy	Biliary cannulation failed within 10 min
Cennamo et al[11]	Wire guided sphincterotome	Biliary cannulation failed within 5 min or 3 unintended pancreatic duct cannulation	Needle knife precut starting at orifice	Biliary cannulation failed within 20 min post randomization
Swan et al[14]	Wire guided sphincterotome	Biliary cannulation failed within 10 min	Needle knife precut starting from superior aspect of orifice	Biliary cannulation failed within 10 min post randomization