Post-sphincterotomy bleeding: fully-covered metal stents for hemostasis

DeBenedet, Anthony T.; Elta, Grace H.

doi:10.12688/f1000research.2-171.v1

Cited by 8 publications

(4 citation statements)

References 15 publications

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“…Smaller diameter stents may become dislodged and may also not achieve a tamponade effect. The distal end of the stent should be beyond the biliary orifice to ensure effective tamponade and the proximal end, if possible, should be distal to the cystic duct takeoff to theoretically reduce the risk of cholecystitis …”

Section: Discussionmentioning

confidence: 99%

Management of postendoscopic sphincterotomy bleeding with fully covered self‐expanding metal stent

Huang

Tsai

Chen

et al. 2019

Adv in Digestive Medicine

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Postendoscopic sphincterotomy (ES) bleeding is one of the most frequent complications following ES. Different endoscopic interventions are available to manage post‐ES bleeding. Recently, the temporary placement of fully covered self‐expanding metal stent (FCSEMS) to achieve a tamponade effect has been described in post‐ES bleeding not controlled by other measures. The aim of this article is to present our clinical experience with management of post‐ES bleeding using FCSEMS. This is a retrospective analysis of prospectively collected data involving six patients who received FCSEMS for post‐ES bleeding after failure of traditional endoscopic interventions between the period of January 2013 and December 2016. Success of hemostasis and development of complications were evaluated. Successful hemostasis was achieved in all patients although one patient required additional endoscopic intervention after stent deployment. Two cases of pancreatitis were observed. There was no stent migration encountered. Temporary placement of FCSEMS is a safe and effective method to achieve hemostasis in post‐ES bleeding when primary endoscopic interventions failed. However, we should be aware of possible pancreatitis complications.

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Section: Discussionmentioning

confidence: 99%

Management of postendoscopic sphincterotomy bleeding with fully covered self‐expanding metal stent

Huang

Tsai

Chen

et al. 2019

Adv in Digestive Medicine

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“…[164][165][166][167] Placing FCSEMS is technically easy and frequently very effective (Fig. 5) to control bleeding.…”

Section: Managementmentioning

confidence: 99%

Endoscopic retrograde cholangiopancreatography complications: Techniques to reduce risk and management strategies

Tarnasky

Kedia

2017

Int J Gastrointest Interv

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Adverse events after endoscopic retrograde cholangiopancreatography (ERCP) are not uncommon and can be associated with tragic outcomes. Bleeding, perforation, and post-ERCP pancreatitis are the most common complications. Some events are unavoidable; others are associated with well described risk factors so that they can be either anticipated and/or measures can be taken for prevention or at least risk reduction. This review will focus on the more common complications after ERCP, their risk factors, and potential strategies for risk reduction. Additionally, recommendations for management of ERCP complications will be presented.

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“…Covered SEMSs have recently been used to treat other benign conditions such as bleeding unresponsive to usual therapies (epinephrine injection, argon plasma coagulation or clip) [41][42][43] and portal hypertensive biliopathy [44,45]. The success rates are optimal and no complications have occurred after removal within a few weeks.…”

Section: Csems and Rare Biliary Complicationsmentioning

confidence: 99%

Covered metal stents in endoscopic therapy of biliary complications after liver transplantation

Cantù

Tenca

Parzanese

et al. 2016

Digestive and Liver Disease

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There is growing interest in using covered self-expandable metal stents for the treatment of benign biliary conditions, and the presence of anastomotic biliary strictures and leaks after liver transplantation provide a valuable opportunity for testing them. The performance of the stents is encouraging, and the technical success rate is high. They provide larger diameter dilation and are easily removed, and can potentially limit costs by reducing the number of procedures needed to treat anastomotic biliary strictures. However, drawbacks such as sub-optimal tolerability and migration may affect both patient management and costs. New stent designs are currently being evaluated. Randomized controlled trials and cost-effectiveness analyses comparing covered metal stents with multiple plastic stent endotherapy are warranted in order to define the role of the former as first-line or rescue treatment.

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Post-sphincterotomy bleeding: fully-covered metal stents for hemostasis

Cited by 8 publications

References 15 publications

Management of postendoscopic sphincterotomy bleeding with fully covered self‐expanding metal stent

Management of postendoscopic sphincterotomy bleeding with fully covered self‐expanding metal stent

Endoscopic retrograde cholangiopancreatography complications: Techniques to reduce risk and management strategies

Covered metal stents in endoscopic therapy of biliary complications after liver transplantation

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