Cochrane · systematic review · CD009662

Guidewire‐assisted cannulation of the common bile duct for the prevention of post‐endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis

Tse, F, Liu, J, Yuan, Y, et al. · Cochrane Database of Systematic Reviews · 2022 · Cochrane Library

Gut2 versionsAMSTAR 2: not assessed

SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.

Questions

current version

GRADE rated

No studies

Included studies

No studies 0 · 0%Ungraded 0 · 0%Very low 1 · 14.3%Low 2 · 28.6%Moderate 4 · 57.1%High 0 · 0%

Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.

Questions and results

Current version only

Guidewire‐assisted cannulation compared to contrast‐assisted cannulation for the prevention of post‐ERCP pancreatitis (PEP)

Population: Patients undergoing diagnostic or therapeutic ERCP

CD009662.PUB3 (current) · 7 questions

Outcome	Effect	Evidence	Status / GRADE
Post‐ERCP pancreatitis (PEP) Guidewire‐assisted cannulation vs contrast‐assisted cannulation	RR 0.51 [0.36, 0.72]	15 studies · 4426 participants	Moderate Downgraded: risk of bias
Primary cannulation success Guidewire‐assisted cannulation vs contrast‐assisted cannulation	RR 1.06 [1.01, 1.12]	13 studies · 3962 participants	Low Downgraded: risk of bias
Overall cannulation success Guidewire‐assisted cannulation vs contrast‐assisted cannulation	RR 1.01 [1, 1.03]	15 studies · 4426 participants	Moderate Downgraded: risk of bias
Need for precut sphincterotomy Guidewire‐assisted cannulation vs contrast‐assisted cannulation	RR 0.79 [0.64, 0.96]	10 studies · 2849 participants	Moderate Downgraded: risk of bias
Post‐sphincterotomy bleeding Guidewire‐assisted cannulation vs contrast‐assisted cannulation	RR 0.87 [0.49, 1.54]	7 studies · 2122 participants	Low Downgraded: risk of bias
Perforation Guidewire‐assisted cannulation vs contrast‐assisted cannulation	RR 0.93 [0.11, 8.23]	8 studies · 2522 participants	Very low Downgraded: risk of bias
Mortality Guidewire‐assisted cannulation vs contrast‐assisted cannulation	no estimate extracted	6 studies · 2276 participants	Moderate Downgraded: risk of bias

Guidewire‐assisted cannulation compared to contrast‐assisted cannulation, main analysis for the prevention of post‐endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis

Population: patients undergoing diagnostic or therapeutic ERCP

CD009662.PUB2 · 1 question

Outcome	Effect	Evidence	Status / GRADE
Post‐ERCP pancreatitis (ITT) Guidewire‐assisted cannulation vs contrast‐assisted cannulation, main analysis	RR 0.51 [0.32, 0.82]	12 studies · 3450 participants	Moderate Downgraded: risk of bias, inconsistency