Comparison between endoscopic sphincterotomy vs endoscopic sphincterotomy associated with balloon dilation for removal of bile duct stones: A systematic review and meta-analysis based on randomized controlled trials

Figure 1 Flow diagram of studies included in the meta-analysis.

Figure 2 Stone removal rate forest plot enrolling all studies.

Figure 3 Funnel plot showing one outlier study in the stone removal rate analysis.

Figure 4 Stone removal rate forest plot after removing the outlier study.

Figure 5 Forest plot of stone removal rate in patients with stones greater than 15 mm.

Figure 6 Forest plot of post-endoscopic retrograde cholangiopancreatography pancreatitis rate.

Figure 7 Forest plot of post-procedure bleeding rate (P = 0. 05).

Figure 8 Forest plot of post-procedure cholangitis rate.

Figure 9 Forest plot with fixed effect comparing the use of mechanical lithotripsy (P < 0. 00001).

Figure 10 Funnel plot showing true heterogeneity in the use of mechanical lithotripsy general analysis.

Figure 11 Forest plot with random effect comparing the use of mechanical lithotripsy (P < 0. 002).

Figure 12 Forest plot with fixed effect comparing the use of mechanical lithotripsy in patients with stones greater than 15 mm (P < 0. 00001).

Figure 13 Funnel plot showing true heterogeneity in the use of mechanical lithotripsy in patients with stones greater than 15 mm analysis.

Figure 14 Forest plot with random effect comparing the use of mechanical lithotripsy in patients with stones greater than 15 mm analysis (P = 0. 03).

Figure 15 Forest plot comparing perforation rates during the procedure.

Figure 16 Flow chart of current clinical approach in our reference service.