SynthesisBMC gastroenterology2026
Systematic review and network meta-analysis: comparison of different techniques for difficult biliary cannulation.
Synthesis in BMC gastroenterology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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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.
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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.
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Who cites it
1 citing paper in PubMed.
- Endoscopic Appearance After Transpancreatic Precut Sphincterotomy: Classification and Implications for Biliary Cannulation.Journal of clinical medicine · 2026Article
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
aimDifficult biliary cannulation (DBC) prolongs endoscopic retrograde cholangiopancreatography (ERCP) manipulation and increases post-ERCP complications. Several cannulation techniques, including guidewire and cutting-based methods, have been proposed to facilitate the procedure; however, the optimum choice among these approaches remains inconclusive. We conducted a network meta-analysis to compare the techniques for DBC.
methodsThree major bibliographic databases were reviewed for enrollment of comparative trials which took place prior to January 23, 2024. We included adults diagnosed with DBC and compared two or more of seven possible interventions, including controlled group, precut papillotomy (PP), precut fistulotomy (PF), delayed precut papillotomy (dPP), delayed precut fistulotomy (dPF), transpancreatic biliary sphincterotomy (TPS), and the double-guidewire technique (DGW). Our focus was on the deep cannulation rate and any post-ERCP complications, including pancreatitis, bleeding, perforation and infection which may have occurred during the follow-up periods.
resultsSeventeen randomised controlled trials involving a total of 2,189 participants were used in the analyses. When compared with the control group, TPS was shown to be significantly superior to the other techniques in cannulation efficacy (OR 6.00, 95% CI: 1.29 ~ 27.96), while only PF was found to be significantly associated with a lower complication rate (OR 0.61, 95% CI: 0.40 ~ 0.93). Subgroup analysis also found that patients receiving PF experienced significantly less post-ERCP pancreatitis in comparison to the control group, with no differences in being seen in bleeding, perforation or infection after ERCP.
conclusionsFor DBC patients, only TPS achieved better cannulation efficacy, while PF showed a lower complication rate with statistical significance, particularly in post-ERCP pancreatitis.
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