Endoscopic Management Using Novel Haemostatic Agents for Immediate Bleeding during Endoscopic Retrograde Cholangio-Pancreatography.

IF 2.7 4区 医学 Q2 Medicine Canadian Journal of Gastroenterology and Hepatology Pub Date : 2023-04-10 eCollection Date: 2023-01-01 DOI:10.1155/2023/5212580
Cosmas Rinaldi Adithya Lesmana, Sharon Sandra, Maria Satya Paramitha, Rino Alvani Gani, Laurentius A Lesmana
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Abstract

Bleeding after endoscopic sphincterotomy (ES) remains as a major challenge during ERCP procedure. Standard endoscopic haemostatic procedures have demonstrated good performance for bleeding control. Novel endoscopic haemostatic agents have also been widely used in gastrointestinal bleeding management. Regardless, there is still a paucity of high-quality evidence evaluating the practicality of these agents in ERCP. This case series study was performed on the patients who underwent ERCP procedure in a tertiary referral private hospital within 2 years period. Post-ES immediate bleeding is defined as the onset of bleeding at the time of sphincterotomy. Treatment groups for post-ES bleeding are divided into (1) standard haemostatic methods and (2) novel haemostatic agents. There were 40 patients who received standard haemostatic treatment and 60 patients who received novel haemostatic agents. Initial haemostasis was achieved in all patients. Two patients who received standard haemostatic treatment had rebleeding. Meanwhile, no patients in novel haemostatic treatment group had rebleeding. In conclusion, novel haemostatic agent can be considered as an easy and practical method in daily practice, especially when an ERCP procedure is performed. Further studies with larger sample size which, if possible, can also include a cost-effectiveness analysis are still required to implement these agents as a standard procedure in clinical practice. (This abstract has been presented at the American College of Gastroenterology meeting October 2021).

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使用新型止血剂处理内镜逆行胰胆管造影术中的即刻出血。
内镜括约肌切开术(ES)后出血仍是ERCP手术中的一大难题。标准的内镜止血程序在控制出血方面表现良好。新型内镜止血剂也已广泛应用于消化道出血治疗。尽管如此,目前仍缺乏高质量的证据来评估这些止血剂在ERCP中的实用性。本病例系列研究的对象是两年内在一家三级转诊私立医院接受ERCP手术的患者。ES后即刻出血的定义是在括约肌切开术时开始出血。ES后出血的治疗组分为(1)标准止血方法和(2)新型止血剂。40 名患者接受了标准止血治疗,60 名患者接受了新型止血剂治疗。所有患者都实现了初步止血。两名接受标准止血治疗的患者出现了再出血。而新型止血剂治疗组则没有患者再出血。总之,新型止血剂在日常实践中是一种简便实用的方法,尤其是在进行ERCP手术时。要在临床实践中将这些止血剂作为标准程序实施,还需要进行样本量更大的进一步研究,如有可能,还需进行成本效益分析。(本摘要已于 2021 年 10 月在美国胃肠病学院会议上发表)。
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来源期刊
CiteScore
4.80
自引率
0.00%
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0
审稿时长
37 weeks
期刊介绍: Canadian Journal of Gastroenterology and Hepatology is a peer-reviewed, open access journal that publishes original research articles, review articles, and clinical studies in all areas of gastroenterology and liver disease - medicine and surgery. The Canadian Journal of Gastroenterology and Hepatology is sponsored by the Canadian Association of Gastroenterology and the Canadian Association for the Study of the Liver.
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