Endoscopic hemostasis with fibrin glue for refractory postsphincterotomy and postpapillectomy bleeding

Area of Science:

• Gastroenterology
• Endoscopic Procedures
• Hemostasis Techniques

Background:

• Bleeding is a significant risk following endoscopic sphincterotomy and papillectomy.
• Fibrin glue is a potential hemostatic agent but faces challenges like needle occlusion.
• Its efficacy in refractory post-ERCP bleeding remains undefined.

Observation:

• A modified technique for endoscopic hemostasis using diluted fibrin glue was developed.
• Six patients with refractory bleeding post-sphincterotomy or papillectomy were treated.
• The technique involved easy submucosal injection of diluted fibrin glue.

Findings:

• A single session of diluted fibrin glue injection achieved hemostasis in all six patients.
• The modified technique facilitated straightforward injection, overcoming previous limitations.
• Refractory post-ERCP bleeding was successfully managed endoscopically.

Implications:

• This modified fibrin glue injection technique offers a promising endoscopic solution for refractory post-ERCP bleeding.
• It may represent an effective and easily applicable hemostatic modality.
• Further studies are warranted to confirm these findings in larger cohorts.