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

Abstract

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.

ERCP Procedures in a Finnish Community Hospital: A Retrospective Analysis of 1207 Cases

“…It has been suggested, that precut sphincterotomy should be used early enough in a difficult cannulation to avoid numerous cannulation attempts and unnecessary injury to the papilla or to the pancreatic duct. Early use of precut sphincterotomy may reduce the risk of pancreatitis (24,25). The second cannulation attempt a few days after precut is usually easier (13,19,20).…”

Early precut fistulotomy for biliary access: time to change the paradigm of “the later, the better”?

“…5,7 There are studies suggesting that early institution of the precut is a safe and effective strategy even though conflicting results concerning post-ERCP adverse events have been reported when compared with conventional techniques. 8 However, these studies have seldomly addressed the impact of the precut timing in the global ERCP duration.…”

Endoscopic retrograde cholangiopancreatography complications: Techniques to reduce risk and management strategies

“…51,[86][87][88][89][90][91] Meta-analyses support early precut when compared to ongoing cannulation attempts. [92][93][94] Definition of "early" and the precut technique are other variables. Lee et al 95 reported results using a sequential approach that involved "early" precut.…”