Study designs of evaluations included in the review
Randomised controlled trials (RCTs) with no loss to follow-up were eligible for inclusion in the review.
Specific interventions included in the review
Studies comparing pure versus mixed electrosurgical current for endoscopic biliary sphincterotomy were eligible for inclusion. Studies of pancreatic sphincterotomy were excluded from the review, as were studies where other prophylactic or therapeutic interventions were used in either treatment arm. The following interventions were excluded from the meta-analysis: electrosurgery using a sequential combination of different types of current along the length of the sphincterotomy; electrosurgery via needle-knife sphincterotomy; and pancreatic sphincterotomy or combined biliary and pancreatic sphincterotomy. Two of the four included studies compared the Valleylab Force 2 generator using 30 Watts/second pure current versus 30 Watts/second combined current.
Participants included in the review
Studies of patients undergoing endoscopic biliary sphincterotomy during endoscopic retrograde cholangiopancreatography (ERCP) were eligible for inclusion. The mean age of included participants ranged from 53 to 64 years, and the ratio of males to females ranged from 1:1.05 to 1:3.1.
Outcomes assessed in the review
Eligible studies had to report levels of complications including bleeding, perforation and post-ERCP pancreatitis. Complications were graded according to the consensus criteria for pancreatitis; bleeding was graded according to severity (mild, moderate or severe).
How were decisions on the relevance of primary studies made?
The authors did not state how the papers were selected for the review, or how many reviewers performed the selection.