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Post-sphincterotomy bleeding: fully-covered metal stents for hemostasis

Background/objectives: In endoscopic retrograde cholangiopancreatography, post-sphincterotomy bleeding (PSB) is a common complication of biliary sphincterotomy. Recently, the temporary placement of fully-covered metal stents (FCMS) into the biliary tree in order to achieve a tamponade effect has bee...

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Autores principales: DeBenedet, Anthony T, Elta, Grace H
Formato: Online Artículo Texto
Lenguaje:English
Publicado: F1000Research 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3869479/
https://www.ncbi.nlm.nih.gov/pubmed/24555084
http://dx.doi.org/10.12688/f1000research.2-171.v1
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author DeBenedet, Anthony T
Elta, Grace H
author_facet DeBenedet, Anthony T
Elta, Grace H
author_sort DeBenedet, Anthony T
collection PubMed
description Background/objectives: In endoscopic retrograde cholangiopancreatography, post-sphincterotomy bleeding (PSB) is a common complication of biliary sphincterotomy. Recently, the temporary placement of fully-covered metal stents (FCMS) into the biliary tree in order to achieve a tamponade effect has been described as an additional therapeutic option for PSB. The aim of this article is to review the literature on FCMS for hemostasis in PSB and update the treatment algorithm for this complication. Methods: A PubMed literature search was conducted using the search terms post-sphincterotomy, bleeding, and stent. 33 articles were reviewed, along with their references, and four were found to describe the use of FCMS for hemostasis in PSB. Results: A total of 21 patient cases were described in the four articles. All patients received FCMS for PSB hemostasis following the application and subsequent failure of traditional therapies (conventional pharmacologic injection, thermal or electrocoagulation, and mechanical therapy (balloon tamponade or endoclip)). Successful hemostasis was achieved in all patients through FCMS placement. No major complications were observed.    Conclusion: These 21 cases demonstrate that FCMS are a viable therapeutic option for PSB.  It is reasonable to consider stent placement for patients in which traditional interventions fail in order to avoid the need for angiographic or surgical hemostasis.
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spelling pubmed-38694792013-12-27 Post-sphincterotomy bleeding: fully-covered metal stents for hemostasis DeBenedet, Anthony T Elta, Grace H F1000Res Review Article Background/objectives: In endoscopic retrograde cholangiopancreatography, post-sphincterotomy bleeding (PSB) is a common complication of biliary sphincterotomy. Recently, the temporary placement of fully-covered metal stents (FCMS) into the biliary tree in order to achieve a tamponade effect has been described as an additional therapeutic option for PSB. The aim of this article is to review the literature on FCMS for hemostasis in PSB and update the treatment algorithm for this complication. Methods: A PubMed literature search was conducted using the search terms post-sphincterotomy, bleeding, and stent. 33 articles were reviewed, along with their references, and four were found to describe the use of FCMS for hemostasis in PSB. Results: A total of 21 patient cases were described in the four articles. All patients received FCMS for PSB hemostasis following the application and subsequent failure of traditional therapies (conventional pharmacologic injection, thermal or electrocoagulation, and mechanical therapy (balloon tamponade or endoclip)). Successful hemostasis was achieved in all patients through FCMS placement. No major complications were observed.    Conclusion: These 21 cases demonstrate that FCMS are a viable therapeutic option for PSB.  It is reasonable to consider stent placement for patients in which traditional interventions fail in order to avoid the need for angiographic or surgical hemostasis. F1000Research 2013-08-12 /pmc/articles/PMC3869479/ /pubmed/24555084 http://dx.doi.org/10.12688/f1000research.2-171.v1 Text en Copyright: © 2013 DeBenedet AT et al. http://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Review Article
DeBenedet, Anthony T
Elta, Grace H
Post-sphincterotomy bleeding: fully-covered metal stents for hemostasis
title Post-sphincterotomy bleeding: fully-covered metal stents for hemostasis
title_full Post-sphincterotomy bleeding: fully-covered metal stents for hemostasis
title_fullStr Post-sphincterotomy bleeding: fully-covered metal stents for hemostasis
title_full_unstemmed Post-sphincterotomy bleeding: fully-covered metal stents for hemostasis
title_short Post-sphincterotomy bleeding: fully-covered metal stents for hemostasis
title_sort post-sphincterotomy bleeding: fully-covered metal stents for hemostasis
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3869479/
https://www.ncbi.nlm.nih.gov/pubmed/24555084
http://dx.doi.org/10.12688/f1000research.2-171.v1
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