Document Detail


Treating delayed endoscopic sphincterotomy-induced bleeding: epinephrine injection with or without thermotherapy.
MedLine Citation:
PMID:  19824118     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIM: To compare the hemostatic efficacy between epinephrine injection alone and epinephrine injection combined with thermotherapy for delayed post-endoscopic sphincterotomy (ES) bleeding.
METHODS: Cases with delayed post-ES bleeding undergoing epinephrine injection alone (epinephrine injection group, n = 26) or epinephrine combined with thermotherapy (combination therapy group, n = 33) in our institution between 1999 and 2007 were retrospectively investigated. The main outcome measurements were: initial endoscopic hemostasis, re-bleeding, complications, requirement of angiographic embolization or surgery, requirement for blood transfusion, and mortality.
RESULTS: The initial hemostatic efficacy was 96.2% for epinephrine injection alone and 100% for combination therapy (P = 0.44). There were four patients with re-bleeding in each group (16.0% vs 12.1%, P = 0.72). There was only one complication of pancreatitis from the combination therapy group. Three patients (11.5%) in the epinephrine injection group and one patient (3%) in the combination therapy group required angiographic embolization or surgery (P = 0.31). The total number of blood transfusions was not significantly different between the two groups (3.5 +/- 4.6 U vs 3.5 +/- 4.5 U, P = 0.94). There was no bleeding-related death in either group.
CONCLUSION: Epinephrine injection alone is as effective as epinephrine injection combined with thermotherapy for the management of delayed post-ES bleeding.
Authors:
Yung-Kuan Tsou; Cheng-Hui Lin; Nai-Jen Liu; Jui-Hsiang Tang; Kai-Feng Sung; Chi-Liang Cheng; Ching-Song Lee
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  World journal of gastroenterology : WJG     Volume:  15     ISSN:  2219-2840     ISO Abbreviation:  World J. Gastroenterol.     Publication Date:  2009 Oct 
Date Detail:
Created Date:  2009-10-13     Completed Date:  2010-01-27     Revised Date:  2014-05-20    
Medline Journal Info:
Nlm Unique ID:  100883448     Medline TA:  World J Gastroenterol     Country:  China    
Other Details:
Languages:  eng     Pagination:  4823-8     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Aged
Cholangiopancreatography, Endoscopic Retrograde / methods*
Endoscopy / methods
Epinephrine / pharmacology*
Female
Hemorrhage
Hemostasis
Humans
Hyperthermia, Induced / methods*
Male
Middle Aged
Retrospective Studies
Sphincterotomy, Endoscopic / adverse effects*
Treatment Outcome
Vasoconstrictor Agents / pharmacology
Chemical
Reg. No./Substance:
0/Vasoconstrictor Agents; YKH834O4BH/Epinephrine
Comments/Corrections

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