TABLE 7.
PICO question 3: Large balloon papillary dilation Dsphincterotomy compared with sphincterotomy alone for large choledocholithiasis
| Certainty assessment |
No. of patients |
Effect |
||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| No. of studies | Study design |
Risk of bias | Inconsistency | Indirectness | Imprecision | Other considerations | Papillary dilation + sphincterotomy |
Sphincterotomy alone |
Relative (95% CI) |
Absolute (95% CI) | Certainty | Importance |
| Overall clearance | ||||||||||||
| 9 | Randomized trials | Not serious | Not serious | Not serious | Serious* | None | 534/551 (96.9%) | 500/551 (90.7%) | OR 2.8 (1.4-5.7) | 57 more per 1000 (from 25 more to 75 more) | ⊕⊕⊕○ MODERATE |
CRITICAL |
| Need for mechanical lithotripsy | ||||||||||||
| 8 | Randomized trials | Not serious | Not serious | Not serious | Serious* | None | 50/551 (9.1%) | 144/551 (26.1%) | OR .27 (.16-.46) | 174 fewer per 1000 (from 121 fewer to 208 fewer) | ⊕⊕⊕○ MODERATE |
CRITICAL |
| All adverse events | ||||||||||||
| 8 | Randomized trials | Not serious | Not serious | Not serious | Serious* | None | 33/551 (6.0%) | 45/551 (8.2%) | OR .79 (.45-1.38) | 16 fewer per 1000 (from 28 more to 43 fewer) | ⊕⊕⊕○ MODERATE |
CRITICAL |
CI, Confidence interval; OR, odds ratio
*
We rated down for imprecision because of wide confidence intervals.