Biliary hemostasis using an endoscopic plastic stent placement for uncontrolled hemobilia caused by transpapillary forceps biopsy (with video)

Shinjo, Kunihiro; Matsubayashi, Hiroyuki; Matsui, Toru; Kawata, Noboru; Uemura, Sunao; Yamamoto, Yusuke; Ono, Hiroyuki

doi:10.1007/s12328-016-0637-8

Cited by 15 publications

(5 citation statements)

References 9 publications

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“…Previous studies have shown variations in post-ERCP bleeding rates ranging from 0.3% to 1.3%. [1819] Some rare intraductal bleeding and hematomas had been reported,[202122] but most ERCP-associated hemorrhage is intraluminal. Previous studies also showed that the postprocedure hemorrhage rate was lower for EPBD than for EST in a normal population[11] and that EPBD significantly reduced the risk of post-ERCP bleeding when compared with EST application in patients with advanced cirrhosis and coagulopathy.…”

Section: Discussionmentioning

confidence: 99%

Major bleeding risk of endoscopic sphincterotomy versus endoscopic papillary balloon dilatation in hemodialysis patients

Tsai

Wang

Yang

et al. 2019

Saudi J Gastroenterol

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Background/Aims: Endoscopic sphincterotomy (EST) and endoscopic papillary balloon dilatation (EPBD) are used for therapeutic endoscopic retrograde cholangiopancreatography (ERCP). The postprocedure bleeding rate for EPBD is low in the normal population; however, this bleeding rate in a group of patients prone to bleeding, such as patients with end-stage renal disease, is not well-established. We therefore evaluated the post-EST and post-EPBD bleeding rate among hemodialysis (HD) patients based on data from Taiwan's National Health Insurance Research Database (NHIRD). Patients and Methods: The NHIRD entries for a population of 2 million were screened for patients who had a catastrophic illness card for HD between 1 st January 2004 and 31 st December 2011 and these patients were enrolled as research subjects. The rates of major gastrointestinal tract bleeding events appearing within 14 days after EST or EPBD were compared between HD and non-HD patients. Results: A total of 3561 patients, over 18 years of age and without liver cirrhosis or hematologic diseases, underwent 3826 EST and 280 EPBD procedures during the 8 calendar years selected for our analysis. The total post-ERCP major bleeding rate was much higher in HD than in non-HD patients (8.64% vs. 2.16%, P < 0.0001). The rate of postprocedure major bleeding events was lower for non-HD patients who underwent EPBD than those who underwent EST (0.75% vs. 2.26%; P = 0.049), whereas the postprocedure major bleeding event rates were similar in HD patients who underwent either EPBD or EST (8.70% vs. 8.33%; P = 0.484). Conclusion: Post-ERCP, post-EST, and post-EPBD major bleeding rates were all higher in HD patients in this study. EPBD resulted in lower postprocedure major bleeding events than EST in the non-HD population, but it failed to provide the reduction in bleeding events needed to perform endoscopic hemostasis in HD patients.

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Section: Discussionmentioning

confidence: 99%

Major bleeding risk of endoscopic sphincterotomy versus endoscopic papillary balloon dilatation in hemodialysis patients

Tsai

Wang

Yang

et al. 2019

Saudi J Gastroenterol

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“…Therefore, biliary obstruction causes cholangitis. The combination of EBPS and an NBD catheter to prevent cholangitis is an alternative hemostatic tool to the CSEMS that reduces the risk of post-procedural pancreatitis [ 69 ].…”

Section: Endoscopic Management Of Specific Complicationsmentioning

confidence: 99%

An Update on Endoscopic Management of Post-Liver Transplant Biliary Complications

2017

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Biliary complications are the most common post-liver transplant (LT) complications with an incidence of 15%–45%. Furthermore, such complications are reported more frequently in patients who undergo a living-donor LT compared to a deceased-donor LT. Most post-LT biliary complications involve biliary strictures, bile leakage, and biliary stones, although many rarer events, such as hemobilia and foreign bodies, contribute to a long list of related conditions. Endoscopic treatment of post-LT biliary complications has evolved rapidly, with new and effective tools improving both outcomes and success rates; in fact, the latter now consistently reach up to 80%. In this regard, conventional endoscopic retrograde cholangiopancreatography remains the preferred initial treatment. However, percutaneous transhepatic cholangioscopy is now central to the management of endoscopy-resistant cases involving complex hilar or multiple strictures with associated stones. Many additional endoscopic tools and techniques—such as the rendezvous method, magnetic compression anastomosis , and peroral cholangioscopy—combined with modified biliary stents have significantly improved the success rate of endoscopic management. Here, we review the current status of endoscopic treatment of post-LT biliary complications and discuss conventional as well as the aforementioned new tools and techniques.

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“…In malignant cases, the causal arteries are often involved in the tumors; therefore, their running direction and fragility are altered. Even a superficial forceps biopsy can cause pulsative arterial bleeding (20). In addition to the mucosal necrosis due to cancer invasion, luminal compression by the stents and the effects of chemotherapies before and after the stenting are considered risk factors for PA rupture.…”

Section: Discussionmentioning

confidence: 99%

Rupture of Pseudoaneurysm after Biliary Metallic Stent Placement

et al. 2019

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Rupture of a pseudoaneurysm (PA) has been reported as a rare but serious adverse event associated with endoscopic biliary stenting. We herein report 2 cases of severe biliary bleeding from a PA that developed 10-14 days after placement of a self-expandable metallic stent (SEMS) for biliary malignancy. The first patient was successfully embolized with endovascular coiling. However, the second patient had wide-spreading cholangiocarcinoma and, despite being treated once by full coiling, developed a second rupture of PA two months after starting systemic chemotherapy. Clinicians should be aware of the possibility of PA and carefully follow stented patients after endovascular treatment.

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Biliary hemostasis using an endoscopic plastic stent placement for uncontrolled hemobilia caused by transpapillary forceps biopsy (with video)

Cited by 15 publications

References 9 publications

Major bleeding risk of endoscopic sphincterotomy versus endoscopic papillary balloon dilatation in hemodialysis patients

Major bleeding risk of endoscopic sphincterotomy versus endoscopic papillary balloon dilatation in hemodialysis patients

An Update on Endoscopic Management of Post-Liver Transplant Biliary Complications

Rupture of Pseudoaneurysm after Biliary Metallic Stent Placement

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