Surgical Endoscopy

, Volume 24, Issue 11, pp 2670–2680 | Cite as

Does precut technique improve selective bile duct cannulation or increase post-ERCP pancreatitis rate? A meta-analysis of randomized controlled trials

  • Biao Gong
  • Lixiao Hao
  • Like Bie
  • Bo Sun
  • Mei Wang



There is no clear answer regarding use of precut technique versus conventional method in achieving successful biliary cannulation.


To compare the effectiveness of precut technique with that of conventional biliary cannulation by meta-analysis of available randomized controlled trials (RCTs).


Databases including MEDLINE, EMBASE, Cochrane Library, and Science Citation Index updated to July 2009 were searched. Main outcome measures were success rates of biliary cannulation, incidence of post-endoscopic retrograde cholangiopancreatography (ERCP) complications, and post-ERCP pancreatitis rate. Meta-analysis of these clinical trials was performed.


Six RCTs were included. The primary biliary cannulation rate reported with precut and conventional techniques was 89.3 and 78.1%, respectively. Pooled analysis of all selected studies comparing precut cannulation technique with conventional techniques yielded an odds ratio (OR) of 2.05 [95% confidence interval (CI): 0.64–6.63]. Pooled analysis comparing post-ERCP pancreatitis rates for the precut-cannulation groups with those for the conventional-method groups yielded an rate ratio (RR) of 0.46 (95% CI: 0.23–0.92).


This meta-analysis shows that the precut technique does not increase the primary cannulation rate. However, the technique reduces the risk of post-ERCP pancreatitis compared with conventional technique. Further large, well-performed, randomized controlled studies are needed to confirm these findings.


Endoscopic retrograde cholangiopancreatography Precut endoscopic biliary sphincterotomy Cannulation Common bile duct Complications Meta-analysis 



Drs. Lixiao Hao, Biao Gong, Like Bie, and Bo Sun have no conflicts of interest or financial ties to disclose.


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Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Biao Gong
    • 1
  • Lixiao Hao
    • 2
  • Like Bie
    • 1
  • Bo Sun
    • 3
  • Mei Wang
    • 4
  1. 1.Digestive Endoscopy Center, Department of Gastroenterology, Runjin HospitalShanghai Jiaotong University School of MedicineShanghaiChina
  2. 2.Department of Hepatobiliary SurgeryThe 455st Hospital of Chinese People’s Liberation ArmyShanghaiChina
  3. 3.Department of GastroenterologyShanghai Gleneagles Medical Center, Parkwany Health (China and North Asia)ShanghaiChina
  4. 4.Department of Oncology, Changai HospitalSecond Military Medical UniversityShanghaiChina

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