Endoscopic hemostasis using covered metallic stent placement for uncontrolled post-endoscopic sphincterotomy bleeding

Area of Science:

• Gastroenterology
• Endoscopic Procedures
• Interventional Endoscopy

Background:

• Severe bleeding post-endoscopic biliary sphincterotomy (EBS) poses management challenges, often necessitating invasive interventions.
• Current hemostatic techniques may be insufficient for controlling significant hemorrhage after EBS.

Purpose of the Study:

• To retrospectively evaluate the feasibility and efficacy of endoscopic hemostasis using covered self-expandable metallic stents (SEMSs) for severe post-EBS bleeding.

Main Methods:

• Eleven patients with bile duct stones underwent EBS.
• Initial hemostasis attempts included balloon tamponade, injection therapy, or endoclip placement.
• Covered SEMSs were deployed across the major papilla for uncontrolled bleeding.

Main Results:

• Complete hemostasis was achieved in all patients following covered SEMS placement.
• The mean stent duration was 8.2 days, with successful removal in all cases.
• No control patients were included, and the sample size was small.

Conclusions:

• Covered SEMS placement is a potentially useful endoscopic hemostasis technique for selected patients with uncontrolled post-EBS bleeding.
• This approach may offer an alternative to more invasive procedures for managing severe hemorrhage after EBS.