Objectives: Endoscopic sphincterotomy (ES) and papillectomy (EP) are associated with a non-negligible risk of post-procedural bleeding. Despite first-line endoscopic hemostasis being achieved by several methods, patients may experience bleeding persistence or recurrence. In such cases, fibrin glue (FG) injection may be used as a rescue therapy before more invasive approaches. The aim of this study was to evaluate the efficacy and safety of endoscopic FG injection to treat refractory post-ES and post-EP bleeding.
Methods: Data were collected retrospectively from patients with refractory immediate or delayed bleeding following ES or EP, between October 2007 and November 2019, at a single institution. Clinical success was defined as bleeding control after FG injection.
Results: Overall, 70 patients were included. Clinical success was reached in 64 (91.4%) patients after one session of FG injection. Of six (8.6%) patients in whom the treatment failed, one required subsequent insertion of a fully covered self-expanding metal stent (FC-SEMS) due to immediate massive bleeding, while five experienced bleeding recurrence. Such events were managed with an additional session of FG injection that failed in two cases. Therefore, one patient underwent FC-SEMS plus selective embolization, whereas the other underwent diagnostic arteriography. No severe periprocedural complications occurred. Two cases of intrabiliary glue migration were treated by endoscopic removal with a retrieval basket.
Conclusions: Rescue therapy with endoscopic FG injection appears to be effective and safe to treat refractory post-ES and post-EP bleeding. Further studies are required to confirm these preliminary data.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1111/den.13857 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Gelatin-DOPA-knob/fibrinogen hydrogel inspired by fibrin polymerization and mussel adhesion for rapid and robust hemostatic sealing.
Biomaterials
December 2024
Department of Hepatobiliary and Pancreatic Surgery, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang, Hangzhou, 310009, China; Key Laboratory of Precision Diagnosis and Treatment for Hepatobiliary and Pancreatic Tumor of Zhejiang Province, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang, Hangzhou, 310009, China. Electronic address:
Tissue adhesives have attracted significant interest in the field of hemostasis. However, challenges including weak tissue adhesion, inadequate biocompatibility, and instability limit their clinical applications. Here, we have developed a gelatin-DOPA-knob/fibrinogen hydrogel inspired by the fibrin polymerization and mussel adhesion, resulting in a biocompatible bioadhesive with outstanding adhesion performance and great storage stability.
View Article and Find Full Text PDFCould Fibrin Sealants (TISSEEL) Be Effective in the Management of Burn Injuries? A Histopathological Study in Rats.
Med Sci (Basel)
December 2024
Laboratory of Experimental Surgery and Surgical Research "N.S. Christeas", School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece.
Burn injuries remain a major clinical problem worldwide, which require special management by experienced plastic surgeons. However, they cannot be available in every healthcare unit; consequently, there is a need for effective treatment options that could be utilized by a wide range of non-expert healthcare professionals. The aim of the present experimental study was to investigate the safety and efficacy of using a fibrin sealant (TISSEEL) compared to the conventional treatment with sulfadiazine on partial-thickness burn in a rat animal model.
View Article and Find Full Text PDFTreatment of superficial corneal opacities with corneal stromal lenticule obtained through SMILE surgery.
Int J Ophthalmol
December 2024
Hainan Eye Hospital and Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Haikou 570311, Hainan Province, China.
Aim: To evaluate the clinical efficacy and feasibility of superficial corneal opacities treated by excimer laser phototherapeutic keratectomy (PTK) combined with small incision lenticule extraction (SMILE)-derived corneal stromal lenticule transplantation.
Methods: A retrospective interventional case series of nine patients aged 12-59y with superficial corneal opacity caused by different pathologies who underwent standardized PTK combined with SMILE-derived corneal stromal lenticule transplantation was examined. Lenticule patches were fixed with fibrin glue.
Enhancing the Efficacy of Radiation Therapy by Photochemical Internalization of Fibrin-Hydrogel-Delivered Bleomycin.
Cancers (Basel)
November 2024
Beckman Laser Institute, University of California, Irvine, CA 92617, USA.
Background/objectives: Although the use of radiation-sensitizing agents has been shown to enhance the effect of radiation on tumor cells, the blood-brain barrier (BBB) impedes these agents from reaching brain tumor sites when provided systemically. Localized methods of sensitizer delivery, utilizing hydrogels, have the potential to bypass the blood-brain barrier. This study examined the ability of photochemical internalization (PCI) of hydrogel-released bleomycin to enhance the growth-inhibiting effects of radiation on multi-cell glioma spheroids in vitro.
View Article and Find Full Text PDFEfficacy of Fibrin Sealant in Submental Liposuction: A Prospective Randomized Study.
Aesthetic Plast Surg
December 2024
Tokyo Chuo Beauty Clinic, K's Square Building 3F, 2-8-15 Sonezaki, Kita-ku, Osaka-shi, Osaka-fu, UmedaOsaka, Japan.
Background: The incidence rate of submental liposuction has been increasing in recent years. Although this procedure is relatively simple, serious complications, including fatalities, have been reported, primarily owing to intraoperative and postoperative bleeding.
Methods: To enhance the safety of liposuction, we examined the efficacy of Beriplast® P (CSL Behring, Melbourne, Australia), a physiological tissue adhesive fibrin sealant, in reducing postoperative swelling.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!