Management of Bleeding After Endoscopic Biliary Sphincterotomy in Patients With or Without Coagulopathy Defects

Seddik, H; Al-Kurdi, Mohamed Mohamed; Attia, Sameh

doi:10.21608/amj.2020.120556

Cited by 1 publication

(2 citation statements)

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“…Nonetheless, anatomical position of papilla, difficulty to push the injection needle out from the sheath, the rotation of hemoclip due to acute angulation directed by duodenoscope elevator, and risk of bleeding at the injection site can sometimes lead to possible morbid complications. Other potential side effects, such as pancreatitis and cholangitis, also need to be considered after these procedures [ 15 , 19 , 20 ]. Another option for treatment, such as endoscopic balloon compression at the bleeding site of the papilla is also a common procedure as it is easier to perform.…”

Section: Discussionmentioning

confidence: 99%

“…Unfortunately, the evidence of its efficacy is still insufficient. In addition, the technical applicability also highly depends on how extensive the sphincterotomy procedure can be performed [ 20 ]. The balloon dilatation method for large or difficult common bile duct (CBD) stones extraction may also elevate the risk of pancreatitis, bleeding, and perforation [ 21 ].…”

Section: Discussionmentioning

confidence: 99%

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Endoscopic Management Using Novel Haemostatic Agents for Immediate Bleeding during Endoscopic Retrograde Cholangio-Pancreatography

Lesmana

Sandra

Paramitha

et al. 2023

Canadian Journal of Gastroenterology and Hepatology

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Bleeding after endoscopic sphincterotomy (ES) remains as a major challenge during ERCP procedure. Standard endoscopic haemostatic procedures have demonstrated good performance for bleeding control. Novel endoscopic haemostatic agents have also been widely used in gastrointestinal bleeding management. Regardless, there is still a paucity of high-quality evidence evaluating the practicality of these agents in ERCP. This case series study was performed on the patients who underwent ERCP procedure in a tertiary referral private hospital within 2 years period. Post-ES immediate bleeding is defined as the onset of bleeding at the time of sphincterotomy. Treatment groups for post-ES bleeding are divided into (1) standard haemostatic methods and (2) novel haemostatic agents. There were 40 patients who received standard haemostatic treatment and 60 patients who received novel haemostatic agents. Initial haemostasis was achieved in all patients. Two patients who received standard haemostatic treatment had rebleeding. Meanwhile, no patients in novel haemostatic treatment group had rebleeding. In conclusion, novel haemostatic agent can be considered as an easy and practical method in daily practice, especially when an ERCP procedure is performed. Further studies with larger sample size which, if possible, can also include a cost-effectiveness analysis are still required to implement these agents as a standard procedure in clinical practice. (This abstract has been presented at the American College of Gastroenterology meeting October 2021).

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%