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Hemoclip treatment for post-endoscopic sphincterotomy bleeding
Lien-Fu Lin1, Chuan-Pau Siauw, Ka-Sic Ho
1Division of Gastroenterology, Department of Internal Medicine, Wuchi Tung's Taichung Metroharbor Hospital, Taichung, Taiwan, ROC. lienfu42@ms10.hinet.net
Journal of the Chinese Medical Association : JCMA
|January 15, 2005
Summary
Hemoclipping effectively treated post-endoscopic sphincterotomy bleeding in 88.8% of cases, offering an alternative to traditional methods. This study demonstrates hemoclip utility for managing bleeding after endoscopic sphincterotomy (EST).
Area of Science:
- Gastroenterology
- Endoscopic Surgery
- Interventional Endoscopy
Background:
- Bleeding after endoscopic sphincterotomy (EST) occurs in 2%-12.1% of patients.
- Existing endoscopic treatments like injection and thermal therapy have limitations, including recurrent bleeding and injury risks.
- Hemoclip management for post-EST bleeding is minimally reported, highlighting a need for further investigation.
Purpose of the Study:
- To evaluate the efficacy and safety of hemoclipping for managing post-endoscopic sphincterotomy bleeding.
- To assess hemoclipping as an alternative hemostatic method in cases of post-EST hemorrhage.
Main Methods:
- A retrospective analysis of 162 endoscopic sphincterotomy (EST) cases was conducted between March 1999 and May 2003.
- Nine patients (5.5%) experiencing post-EST bleeding were treated with hemoclips, with 4 cases involving recurrent bleeding after ineffective epinephrine injection.
- Hemoclips were applied as primary treatment in 5 cases and secondary treatment in 4 cases.
Main Results:
- An 88.8% hemostasis success rate was achieved with hemoclips, including 4 cases of recurrent major bleeding.
- Six cases presented with major bleeding, requiring blood transfusion in 3 patients (mean 7.3 units).
- No complications related to hemoclip application were observed; one failed case required surgery due to massive bleeding obscuring visualization.
Conclusions:
- Hemoclipping presents a viable alternative method for achieving hemostasis in patients experiencing bleeding after endoscopic sphincterotomy.
- The technique demonstrated a high success rate and a favorable safety profile in this patient cohort.