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Endoscopic therapy (endoscopic retrograde cholangiopancreatography with biliary endoscopic sphincterotomy -- ERCP/ES) has been advocated for the management of acute biliary pancreatitis. Four randomized, controlled trials (3 in peer-reviewed publications and 1 abstract) that compared the outcome of endoscopic therapy with conservative therapy produced conflicting results. These authors performed a meta-analysis of these 4 studies involving 460 patients and 374 controls to estimate the overall efficacy and safety of endoscopic intervention.
Each trial reported a numerical reduction in the complication rates of acute biliary pancreatitis with ERCP/ES when compared with conservative therapy, but the difference between groups reached statistical…