Post-sphincterotomy bleeding: fully-covered metal stents for hemostasis

Area of Science:

• Gastroenterology
• Interventional Endoscopy

Background:

• Post-sphincterotomy bleeding (PSB) is a frequent complication following biliary sphincterotomy.
• Fully-covered metal stents (FCMS) offer a tamponade effect for managing PSB.

Purpose of the Study:

• To review the literature on FCMS for PSB hemostasis.
• To update the treatment algorithm for PSB.

Main Methods:

• PubMed literature search using terms: post-sphincterotomy, bleeding, stent.
• Review of 33 articles, focusing on four describing FCMS for PSB hemostasis.

Main Results:

• Analysis of 21 patient cases where FCMS was used after traditional therapies failed.
• Successful hemostasis achieved in all patients with FCMS placement.
• No major complications reported with FCMS use.

Conclusions:

• FCMS represent a viable therapeutic option for PSB.
• Consider FCMS placement when traditional interventions for PSB are unsuccessful.
• FCMS can help avoid angiographic or surgical hemostasis.