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Risk factors for delayed hemorrhage after endoscopic sphincterotomy
Jing Yan1, Chun-Xia Zhou1, Chong Wang1
1Department of Gastroenterology, The First Affiliated Hospital of Nanchang University, Nanchang 330006, China.
Delayed hemorrhage after endoscopic sphincterotomy (EST) is a serious risk. Intraoperative bleeding and incision deviation are key risk factors for this complication, guiding preventative measures.
Area of Science:
- Gastroenterology
- Endoscopic Procedures
- Surgical Complications
Background:
- Hemorrhage is a significant complication following endoscopic sphincterotomy (EST).
- Risk factors for delayed post-EST hemorrhage remain incompletely understood.
- Identifying these factors is crucial for developing preventative strategies.
Purpose of the Study:
- To investigate the risk factors associated with delayed hemorrhage after EST.
- To propose precautionary measures based on identified risk factors.
Main Methods:
- Analysis of 8477 patients undergoing ERCP and EST from January 2007 to June 2015.
- Utilized univariate and multivariate analyses to identify risk factors for delayed hemorrhage.
Main Results:
- 137 patients (1.62%) experienced delayed hemorrhage.
- Univariate analysis identified male gender, jaundice severity, papillary tumors, diabetes, intraoperative bleeding, and incision characteristics as risk factors.
- Multivariate analysis confirmed intraoperative bleeding (OR=3.326) and directional deviation of incision (OR=2.184) as independent risk factors.
Conclusions:
- Delayed hemorrhage is the most frequent and dangerous complication of EST.
- Intraoperative bleeding and directional deviation of the incision are independent predictors of post-EST delayed hemorrhage.
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