Figure 6.

Trial sequential analysis of included trials investigating the incidence of PEP, bleeding, and perforation, and the overall success rates of biliary cannulation of EPS and PCA for DBA patients. (A) The incidence of PEP. (B) The incidence of bleeding. (C) The incidence of perforation. (D) The overall success rates of biliary cannulation. DBA = difficult biliary access, EPS = early precut sphincterotomy, PCA = persistent cannulation attempts, PEP = post-endoscopic retrograde cholangiopancreatography pancreatitis, TSA = trial sequential analysis.