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Related Experiment Videos

Clinically significant delayed postsphincterotomy bleeding: a twelve year single center experience.

L E V V C Ferreira1, J Fatima, T H Baron

  • 1Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic College of Medicine, Rochester, MN, USA.

Minerva Gastroenterologica E Dietologica
|October 4, 2007
PubMed
Summary
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Endoscopy·2013

Delayed bleeding after endoscopic biliary sphincterotomy (ES) is common. Endoscopic therapy effectively controls most cases, but coagulopathy increases severe bleeding risk, necessitating preventive measures.

Area of Science:

  • Gastroenterology
  • Endoscopic Procedures
  • Hemorrhage Management

Background:

  • Bleeding following endoscopic biliary sphincterotomy (ES) contributes to patient morbidity.
  • Identifying endoscopic findings and outcomes in delayed post-ES bleeding is crucial for improving patient care.

Purpose of the Study:

  • To identify endoscopic findings in patients experiencing delayed bleeding after ES.
  • To evaluate the outcomes and risk factors associated with delayed post-ES bleeding.

Main Methods:

  • Retrospective study of 84 patients with delayed post-ES bleeding (1994-2006).
  • Analysis of endoscopic findings, bleeding severity, stigmata of hemorrhage, and endoscopic hemostasis success.
  • Multivariate analysis to identify predictive factors for severe bleeding.

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Main Results:

  • Delayed bleeding occurred in 84 patients, with 15.5% experiencing bleeding during the initial ES.
  • Active bleeding or stigmata of recent hemorrhage were observed in 59.5% and 40.5% of patients, respectively.
  • Coagulopathy was identified as a predictive factor for severe post-ES bleeding.

Conclusions:

  • The majority of significant delayed post-ES bleeding cases present with active bleeding or stigmata of hemorrhage.
  • Endoscopic therapy is highly effective, though multimodal approaches may be needed.
  • Preventive strategies for coagulopathic patients are essential to reduce severe bleeding and morbidity.