AI Article Synopsis
- Bleeding after endoscopic sphincterotomy (EST) is rare but occurs, and local injection of hypertonic saline-epinephrine (HSE) is the standard treatment.
- In a study involving 682 patients, 8 experienced bleeding needing intervention, and all were successfully treated using HSE and pure ethanol to remove clots.
- The method proved effective without any complications, suggesting HSE injections and ethanol for clot removal are safe and beneficial in managing post-EST bleeding.
Article Abstract
Purpose: Bleeding following endoscopic sphincterotomy (EST) is a rare but unavoidable complication of the procedure. We routinely perform local injection of hypertonic saline-epinephrine (HSE) for the treatment of post-EST bleeding. Any blood clot is removed only by irrigation with water after local injection of pure ethanol into the blood clot to cause crusting. We evaluated the usefulness of this treatment method.
Methods: Subjects were 8 patients (1.2%) with post-EST bleeding requiring hemostatic intervention among 682 patients undergoing EST. After determination of the bleeding point, local injection of HSE was performed. When an adherent blood clot was present, pure ethanol was injected into the blood clot and then irrigation with water was performed to remove the blood clot.
Results: Endoscopic hemostasis was successfully achieved in all the 8 patients (100%). In 4 patients (50%), the adherent blood clots were successfully removed only with pure ethanol local injection into the blood clot followed by irrigation with water. No complications of the hemostatic procedure occurred in any patients.
Conclusions: This study indicated that hemostasis with HSE local injection can be safe and useful for the treatment of post-EST bleeding, and also that blood clot removal with pure ethanol local injection can be useful.
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| http://dx.doi.org/10.1097/SLE.0b013e31828b8347 | DOI Listing |
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