AIM: To compare the hemostatic efficacy between epinephrine injection alone and epinephrine injection combined with thermotherapy for delayed post-endoscopic sphincterotomy (ES) bleeding. METHODS: Cases with delayed post-ES bleeding undergoing epinephrine injection alone (epinephrine injection group, n = 26) or epinephrine combined with thermotherapy (combination therapy group, n = 33) in our institution between 1999 and 2007 were retrospectively investigated. The main outcome measurements were: initial endoscopic hemostasis, re-bleeding, complications, requirement of angiographic embolization or surgery, requirement for blood transfusion, and mortality. RESULTS: The initial hemostatic efficacy was 96.2% for epinephrine injection alone and 100% for combination therapy (P = 0.44). There were four patients with re-bleeding in each group (16.0% vs 12.1%, P = 0.72). There was only one complication of pancreatitis from the combination therapy group. Three patients (11.5%) in the epinephrine injection group and one patient (3%) in the combination therapy group required angiographic embolization or surgery (P = 0.31). The total number of blood transfusions was not significantly different between the two groups (3.5 +/- 4.6 U vs 3.5 +/- 4.5 U, P = 0.94). There was no bleeding-related death in either group. CONCLUSION: Epinephrine injection alone is as effective as epinephrine injection combined with thermotherapy for the management of delayed post-ES bleeding.
AIM: To compare the hemostatic efficacy between epinephrine injection alone and epinephrine injection combined with thermotherapy for delayed post-endoscopic sphincterotomy (ES) bleeding. METHODS: Cases with delayed post-ES bleeding undergoing epinephrine injection alone (epinephrine injection group, n = 26) or epinephrine combined with thermotherapy (combination therapy group, n = 33) in our institution between 1999 and 2007 were retrospectively investigated. The main outcome measurements were: initial endoscopic hemostasis, re-bleeding, complications, requirement of angiographic embolization or surgery, requirement for blood transfusion, and mortality. RESULTS: The initial hemostatic efficacy was 96.2% for epinephrine injection alone and 100% for combination therapy (P = 0.44). There were four patients with re-bleeding in each group (16.0% vs 12.1%, P = 0.72). There was only one complication of pancreatitis from the combination therapy group. Three patients (11.5%) in the epinephrine injection group and one patient (3%) in the combination therapy group required angiographic embolization or surgery (P = 0.31). The total number of blood transfusions was not significantly different between the two groups (3.5 +/- 4.6 U vs 3.5 +/- 4.5 U, P = 0.94). There was no bleeding-related death in either group. CONCLUSION:Epinephrine injection alone is as effective as epinephrine injection combined with thermotherapy for the management of delayed post-ES bleeding.
Authors: E Masci; G Toti; A Mariani; S Curioni; A Lomazzi; M Dinelli; G Minoli; C Crosta; U Comin; A Fertitta; A Prada; G R Passoni; P A Testoni Journal: Am J Gastroenterol Date: 2001-02 Impact factor: 10.864
Authors: S Loperfido; G Angelini; G Benedetti; F Chilovi; F Costan; F De Berardinis; M De Bernardin; A Ederle; P Fina; A Fratton Journal: Gastrointest Endosc Date: 1998-07 Impact factor: 9.427
Authors: H J Kim; M H Kim; D I Kim; H J Lee; S J Myung; K S Yoo; E T Park; B C Lim; D W Seo; S K Lee; Y I Min Journal: Endoscopy Date: 1999-08 Impact factor: 10.093
Authors: Yavuz Beyazit; Murat Kekilli; Ibrahim C Haznedaroglu; Ertugrul Kayacetin; Metin Basaranoglu Journal: World J Gastroenterol Date: 2011-09-21 Impact factor: 5.742