Management of Clinically Relevant Bleeding Following Endoscopic Sphincterotomy

Embolization of post-biliary sphincterotomy bleeding refractory to medical and endoscopic therapy: technical results, clinical efficacy and predictors of outcome

“…So et al [7] reported a primary technical success rate of 83 % (10/12 patients), whereas Boujaoudé et al [8] noted successful embolization in four out of five patients (80 %). Similar high technical success rates were also reported for transcatheter embolization of peptic gastroduodenal haemorrhages, ranging between 82 % and 98 % [10][11][12].…”

“…Percutaneous transcatheter embolotherapy is a minimally invasive procedure that can be performed under local anaesthesia, and therefore may be a more attractive alternative than open surgical repair. Several small case series have already demonstrated the feasibility of the percutaneous transcatheter approach, although long-term outcome and predictors of clinical outcome are unknown at this time [7][8][9]. In this study, based on a retrospective analysis of 34 patients, we evaluated the technical results and clinical efficacy of transcatheter embolization of post-EBS bleeding, including an analysis of the predictors of outcome.…”

Factors affecting the success of endoscopic treatment of sphincterotomy bleeding

“…Factors predicting the persistence or recurrence of bleeding after endoscopic treatment are not well studied. There are only a few studies that discuss the reasons of treatment failure and re-bleeding after endoscopic treatment of post-ES bleeding [2,4,9,[21][22][23][24][25][26]. Also there is not a consensus about the treatment of patients with persistant or recurrent bleeding.…”

Endoscopic hemostasis with fibrin glue for refractory postsphincterotomy and postpapillectomy bleeding

“…[1][2][3][4] In the majority of cases, the bleeding stops spontaneously or after endoscopic hemostatic therapy. Endoscopic treatment options include injection with diluted epinephrine, hemoclip placement, or thermal coagulation.…”

“…However, in a minority of cases endoscopic hemostasis fails and the bleeding needs to be stopped radiologically or surgically. 1,4,10 In this subgroup, bleedingrelated mortality has been reported and new therapeutic modalities advocated. 11 In 2000, Born et al 12 suggested that fibrin glue could be considered as a new therapeutic modality for this subgroup of refractory postsphincterotomy bleeding.…”