title: Effect of precut sphincterotomy on post-endoscopic retrograde cholangiopancreatography pancreatitis: a systematic review and meta-analysis.
abstract: OBJECTIVE
  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%.
  
  
  CONCLUSIONS
  Early precut technique for common bile duct cannulation decreases the trend of post-ERCP pancreatitis.
authors.affiliation: Abhishek Choudhary, Jessica Winn, Sameer Siddique, Murtaza Arif, Zainab Arif, Ghassan M Hammoud, Jamal A Ibdah, Matthew L Bechtold, Division of Gastroenterology, Department of Internal Medicine, University of Missouri-Columbia, M580 Health Sciences Center, Columbia, MO 65212, United States.
authors.forename: Abhishek
authors.initials: A
authors.lastname: Choudhary
authors.affiliation: Abhishek Choudhary, Jessica Winn, Sameer Siddique, Murtaza Arif, Zainab Arif, Ghassan M Hammoud, Jamal A Ibdah, Matthew L Bechtold, Division of Gastroenterology, Department of Internal Medicine, University of Missouri-Columbia, M580 Health Sciences Center, Columbia, MO 65212, United States.
authors.forename: Jessica
authors.initials: J
authors.lastname: Winn
authors.affiliation: Abhishek Choudhary, Jessica Winn, Sameer Siddique, Murtaza Arif, Zainab Arif, Ghassan M Hammoud, Jamal A Ibdah, Matthew L Bechtold, Division of Gastroenterology, Department of Internal Medicine, University of Missouri-Columbia, M580 Health Sciences Center, Columbia, MO 65212, United States.
authors.forename: Sameer
authors.initials: S
authors.lastname: Siddique
authors.affiliation: Abhishek Choudhary, Jessica Winn, Sameer Siddique, Murtaza Arif, Zainab Arif, Ghassan M Hammoud, Jamal A Ibdah, Matthew L Bechtold, Division of Gastroenterology, Department of Internal Medicine, University of Missouri-Columbia, M580 Health Sciences Center, Columbia, MO 65212, United States.
authors.forename: Murtaza
authors.initials: M
authors.lastname: Arif
authors.affiliation: Abhishek Choudhary, Jessica Winn, Sameer Siddique, Murtaza Arif, Zainab Arif, Ghassan M Hammoud, Jamal A Ibdah, Matthew L Bechtold, Division of Gastroenterology, Department of Internal Medicine, University of Missouri-Columbia, M580 Health Sciences Center, Columbia, MO 65212, United States.
authors.forename: Zainab
authors.initials: Z
authors.lastname: Arif
authors.affiliation: Abhishek Choudhary, Jessica Winn, Sameer Siddique, Murtaza Arif, Zainab Arif, Ghassan M Hammoud, Jamal A Ibdah, Matthew L Bechtold, Division of Gastroenterology, Department of Internal Medicine, University of Missouri-Columbia, M580 Health Sciences Center, Columbia, MO 65212, United States.
authors.forename: Ghassan M
authors.initials: GM
authors.lastname: Hammoud
authors.affiliation: Abhishek Choudhary, Jessica Winn, Sameer Siddique, Murtaza Arif, Zainab Arif, Ghassan M Hammoud, Jamal A Ibdah, Matthew L Bechtold, Division of Gastroenterology, Department of Internal Medicine, University of Missouri-Columbia, M580 Health Sciences Center, Columbia, MO 65212, United States.
authors.forename: Srinivas R
authors.initials: SR
authors.lastname: Puli
authors.affiliation: Abhishek Choudhary, Jessica Winn, Sameer Siddique, Murtaza Arif, Zainab Arif, Ghassan M Hammoud, Jamal A Ibdah, Matthew L Bechtold, Division of Gastroenterology, Department of Internal Medicine, University of Missouri-Columbia, M580 Health Sciences Center, Columbia, MO 65212, United States.
authors.forename: Jamal A
authors.initials: JA
authors.lastname: Ibdah
authors.affiliation: Abhishek Choudhary, Jessica Winn, Sameer Siddique, Murtaza Arif, Zainab Arif, Ghassan M Hammoud, Jamal A Ibdah, Matthew L Bechtold, Division of Gastroenterology, Department of Internal Medicine, University of Missouri-Columbia, M580 Health Sciences Center, Columbia, MO 65212, United States.
authors.forename: Matthew L
authors.initials: ML
authors.lastname: Bechtold
mesh_terms: D000465:Algorithms; D002404:Catheterization; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000009:adverse effects*; D003135:Common Bile Duct / Q000601:surgery; D006801:Humans; D016017:Odds Ratio; D010195:Pancreatitis / Q000209:etiology; D016032:Randomized Controlled Trials as Topic; D012107:Research Design; D016717:Sphincterotomy, Endoscopic / Q000295:instrumentation / Q000379:methods*; D013997:Time Factors; D016896:Treatment Outcome
keywords: Early precut; Endoscopic retrograde cholangiopancreatography cannulation; Meta-analysis; Post-endoscopic retrograde cholangiopancreatography pancreatitis; Randomized controlled trials
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