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Post-sphincterotomy bleeding after the introduction of microprocessor-controlled electrosurgery: does the new
Rafael F Perini1, Rafal Sadurski, Peter B Cotton
1Charleston, South Carolina, USA.
Gastrointestinal Endoscopy
|January 27, 2005
Summary
The ERBE electrosurgical generator significantly reduced endoscopically observed bleeding during endoscopic sphincterotomy compared to the Valleylab generator. Clinically evident bleeding rates did not differ significantly between the two devices.
Area of Science:
- Gastroenterology
- Medical Devices
- Surgical Technology
Background:
- Bleeding is a known complication of endoscopic sphincterotomy.
- Electrosurgical current generators are used in endoscopic sphincterotomy.
- Different generators may influence complication rates.
Purpose of the Study:
- To compare bleeding rates after endoscopic sphincterotomy using two distinct electrosurgical current generators: Valleylab SSE2L and ERBE ICC200.
- To identify if generator type impacts the frequency of bleeding complications.
Main Methods:
- Retrospective analysis of 6179 ERCP reports.
- Comparison of bleeding frequency between Valleylab SSE2L (Feb 1994-Sep 2000) and ERBE ICC200 (Dec 1997-Sep 2000) groups.
- Statistical analysis including univariate and multiple logistic regression for risk factors.
Main Results:
- Endoscopically observed bleeding occurred in 5.5% (ValleyLab) vs. 1.2% (ERBE) of sphincterotomies.
- The ValleyLab generator was independently associated with increased endoscopically observed bleeding (OR 4.02).
- No significant difference in clinically evident bleeding was observed between the groups.
Conclusions:
- The microprocessor-controlled ERBE generator is associated with lower rates of endoscopically observed bleeding.
- Generator choice may influence the occurrence of visible bleeding during endoscopic sphincterotomy.
- Further research may be needed to confirm clinical significance of observed bleeding differences.