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

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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