Endoscopy 2011; 43(4): 369-372
DOI: 10.1055/s-0030-1256126
Case report/series

© Georg Thieme Verlag KG Stuttgart · New York

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

T.  Itoi1 , I.  Yasuda2 , S.  Doi2 , T.  Mukai3 , T.  Kurihara1 ,  4 , A.  Sofuni1
  • 1Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan
  • 2First Department of Internal Medicine, Gifu University Hospital, Gifu, Japan
  • 3Department of Gastroenterology, Gifu Municipal Hospital, Gifu, Japan
  • 4Department of Gastroenterology and Hepatology, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan
Further Information

Publication History

submitted 26 September 2010

accepted after revision 8 October 2010

Publication Date:
28 February 2011 (online)

Introduction

Endoscopic biliary sphincterotomy (EBS) was developed in 1974 [1] [2] and is considered a milestone in therapeutic endoscopic retrograde cholangiopancreatography (ERCP). Immediate and delayed EBS bleeding is an avoidable adverse event and its incidence has been reported in approximately 1 % – 48 % of cases [3] [4] [5] [6] [7] [8] [9]. It varies between self-limiting and life-threatening bleeding and is occasionally associated with a considerable mortality rate of 0.3 % [3] [4] [5] [6] [7] [8] [9] [10]. Endoscopic interventions include conventional injection therapy, balloon tamponade, application of coagulation current during sphincterotomy, electrocoagulation, hemoclip application, heat probe thermocoagulation, and the use of fibrin glue [6] [8] [10] [11] [12] [13] [14]. Nonetheless, complete hemostasis cannot always be achieved. Herein, we described a new hemostasis technique using a covered self-expandable metallic stent (SEMS) for severe post-EBS bleeding that could not be treated by conventional endoscopic hemostasis.

References

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T. ItoiMD 

Department of Gastroenterology and Hepatology
Tokyo Medical University

6-7-1 Nishishinjuku
Shinjuku-ku
Tokyo, 160–0023
Japan

Fax: +81-3-53816654

Email: itoi@tokyo-med.ac.jp