ArticleClinical endoscopy2026
Safety and efficacy of primary precut techniques for biliary cannulation: a systematic review and meta-analysis.
Article in Clinical endoscopy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
2 citing papers in PubMed.
- Safety and Efficacy of Primary Needle-Knife Fistulotomy in Patients at High Risk for Post-ERCP Pancreatitis: A Prospective Multicenter Pilot Study Comparing Endoscopists with Different Levels of ERCP and NKF Experience.Digestive diseases and sciences · 2026Article
- Needle-knife precut techniques as the initial approach for biliary cannulation: is the evidence sufficient?Clinical endoscopy · 2026Article
Corrections and comments
- Commented on by
Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundBiliary cannulation is a critical component of endoscopic retrograde cholangiopancreatography (ERCP). When standard methods fail, needle-knife precut sphincterotomy (NKPS) is commonly employed. This systematic review and meta-analysis evaluated the safety and efficacy of using NKPS as a primary technique.
methodsElectronic databases were searched for studies published between January 2000 and November 2024 that assessed outcomes of primary precut techniques. "Primary precut" was defined as needle-knife sphincterotomy performed as the initial approach without any prior standard cannulation attempts. Pooled proportions were calculated using random-effects models, and heterogeneity was assessed using the Q-test and the I² statistic.
resultsThe mean patient age was 57.95 years (standard deviation [SD], 7.59), and 53.23% were female. The cannulation success rate was 96.50% (95% confidence interval [CI], 94.90-97.60) with no heterogeneity (Q, 7.10; df, 8; I²=0%; p=0.935). The rates of adverse events were as follows: post-ERCP pancreatitis, 1.90% (95% CI, 1.20-3.10; I²=0; p =0.942); bleeding, 2.60% (95% CI, 1.70-4.00, I²=0; p=0.725); cholangitis, 1.50% (95% CI, 0.60-3.60; I²=45.27; p=0.067); and perforation, 0.90% (95% CI, 0.40-1.90; I²=0; p=0.948). The overall adverse event rate was 9.70% (95% CI, 5.70-16.10; I²=83.39; p<0.001).
conclusionsPrimary precut sphincterotomy appears to be an effective and safe technique for biliary cannulation in ERCP. These findings support its consideration as a viable first-line approach in appropriate clinical settings.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.