Sang Soo Bae1, Dong Wook Lee2, Jimin Han1, Ho Gak Kim1. 1. Division of Gastroenterology and Hepatology, Department of Internal Medicine, Catholic University of Daegu School of Medicine, Daegu, 705-718, South Korea. 2. Division of Gastroenterology and Hepatology, Department of Internal Medicine, Catholic University of Daegu School of Medicine, Daegu, 705-718, South Korea. storm5333@naver.com.
Abstract
BACKGROUND: For therapeutic endoscopic retrograde cholangiopancreatography (ERCP), endoscopic sphincterotomy (ES) is necessary but it can lead to complications such as bleeding. Thus, we investigated the risk factors of post-ES bleeding in average risk patients. METHODS: We retrospectively reviewed the medical records of patients who had been treated for ERCP between April 2006 and March 2013. The length of the ES incision was defined as minimal (up to proximal hooding fold), medium (between minimal and full length), and full (up to superior margin of sphincter opening). Exclusion criteria were as follows: if performed precut sphincterotomy or balloon dilatation, patients having altered anatomy or anticoagulant medications. RESULTS: A total of 3620 patients underwent ERCP and 1121 patients who underwent biliary ES were enrolled. Post-ES bleeding occurred in 108 of 1121 patients (9.6%) and mostly minor bleeding (94 patients, 87%). Length of ES was the only risk factor for post-ES bleeding in multivariate analysis. Complete hemostasis was achieved by endoscopic modalities and no serious complication developed after hemostasis. CONCLUSIONS: In average risk patients, length of ES was independent risk factor for post-ES bleeding and endoscopic hemostasis was safe and effective.
BACKGROUND: For therapeutic endoscopic retrograde cholangiopancreatography (ERCP), endoscopic sphincterotomy (ES) is necessary but it can lead to complications such as bleeding. Thus, we investigated the risk factors of post-ES bleeding in average risk patients. METHODS: We retrospectively reviewed the medical records of patients who had been treated for ERCP between April 2006 and March 2013. The length of the ES incision was defined as minimal (up to proximal hooding fold), medium (between minimal and full length), and full (up to superior margin of sphincter opening). Exclusion criteria were as follows: if performed precut sphincterotomy or balloon dilatation, patients having altered anatomy or anticoagulant medications. RESULTS: A total of 3620 patients underwent ERCP and 1121 patients who underwent biliary ES were enrolled. Post-ES bleeding occurred in 108 of 1121 patients (9.6%) and mostly minor bleeding (94 patients, 87%). Length of ES was the only risk factor for post-ES bleeding in multivariate analysis. Complete hemostasis was achieved by endoscopic modalities and no serious complication developed after hemostasis. CONCLUSIONS: In average risk patients, length of ES was independent risk factor for post-ES bleeding and endoscopic hemostasis was safe and effective.
Authors: Jason D Conway; Douglas G Adler; David L Diehl; Francis A Farraye; Sergey V Kantsevoy; Vivek Kaul; Sripathi R Kethu; Richard S Kwon; Petar Mamula; Sarah A Rodriguez; William M Tierney Journal: Gastrointest Endosc Date: 2009-05 Impact factor: 9.427
Authors: Michelle A Anderson; Tamir Ben-Menachem; S Ian Gan; Vasundhara Appalaneni; Subhas Banerjee; Brooks D Cash; Laurel Fisher; M Edwyn Harrison; Robert D Fanelli; Norio Fukami; Steven O Ikenberry; Rajeev Jain; Khalid Khan; Mary Lee Krinsky; David R Lichtenstein; John T Maple; Bo Shen; Laura Strohmeyer; Todd Baron; Jason A Dominitz Journal: Gastrointest Endosc Date: 2009-11-03 Impact factor: 9.427
Authors: C Mel Wilcox; Jerrold Canakis; Klaus E Mönkemüller; Anthony W Bondora; Wilma Geels Journal: Am J Gastroenterol Date: 2004-02 Impact factor: 10.864
Authors: Eva C Kaltenthaler; Stephen J Walters; Jim Chilcott; Anthony Blakeborough; Yolanda Bravo Vergel; Steven Thomas Journal: BMC Med Imaging Date: 2006-08-14 Impact factor: 1.930
Authors: Mario Gagliardi; Giovanni Oliviero; Michele Fusco; Marco Napoli; Andrea Sica; Attilio Maurano; Mariano Sica; Claudio Zulli Journal: ACG Case Rep J Date: 2022-01-06