Endoscopy 2020; 52(S 01): S258
DOI: 10.1055/s-0040-1704807
ESGE Days 2020 ePoster presentations
Thursday, April 23, 2020 09:00 – 17:00 Clinical endoscopic practice ePoster area
© Georg Thieme Verlag KG Stuttgart · New York

ENDOSCOPIC HEMOSTASIS OF BLEEDING WITH MINIMALLY INVASIVE INTERVENTIONS FOR CHOLEDOCHOLITHIASIS

G Sacchechelashvili
1   MONIKI Clinical Institute, Moscow, Russian Federation
,
A Titaeva
1   MONIKI Clinical Institute, Moscow, Russian Federation
,
S Tereschenko
1   MONIKI Clinical Institute, Moscow, Russian Federation
,
A Plotkin
1   MONIKI Clinical Institute, Moscow, Russian Federation
› Author Affiliations
Further Information

Publication History

Publication Date:
23 April 2020 (online)

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Aims Bleeding from the area of the major duodenal papilla (MDP) is one of the complications of endoscopic transpapillary interventions for choledocholithiasis.

Improving the results of treatment of patients with intra- and postoperative bleeding after minimally invasive interventions for cholelithiasis choledocholithiasis.

Methods 70 cases of bleeding were detected. The patients were divided into two groups: group 1 comprising 46 patients, for whom during hemorrhagic manifestations to reach hemostasis, irrigation and injections of aminocapronic acid was used; and group 2 comprising 24 patients, for whom, with the analogous hemorrhagic manifestations, irrigation and injections of the solution of incomplete silver salt of polyacrylic acid (commercial name “Hemoblock”) was used.

Results Clinically pronounced bleeding; increased bleeding, impeding visualization was noted in 63 (90%) patients: in the control group in 41 (89%), in the main group in 22 (91%).

Bleeding recurrence due to further manipulations (litotripsy, litextraction, etc.) was observed in 14 (20%) patients in the whole patient contingent: in the control group it occurred in 12 (86%) patients, which was significantly more than in the main group, where the recurrence of bleeding was ascertained in 2 (14%) cases (p < 0.05). Transpapillary interventions were carried out in full in one stage in 43 (61.4%) patients, while in the control group in 15 (35%) patients, which was significantly less than in the main group, where the interventions were performed in one stage in 28 (65%) (p < 0.05) patients.

Conclusions Intraorgan application of hemostatic agent “Hemoblock” allowed us to stop the bleeding, improve visualization in the area of the surgical intervention, achieve the result in one stage, reduce the time of the intervention. Complications after the application of a new hemostatic agent (solution of incomplete silver salt of polyacrylic acid) were not observed.