Effect of prophylactic endoscopic clipping for prevention of delayed bleeding after endoscopic papillectomy for ampullary neoplasm: a multicenter randomized trial.
Endoscopy
; 54(8): 787-794, 2022 08.
Article
en En
| MEDLINE
| ID: mdl-35148541
ABSTRACT
BACKGROUND:
Endoscopic clip placement is technically challenging using a duodenoscope, limiting their application for treatment of bleeding after endoscopic papillectomy. This study evaluated the efficacy of newly designed clips to prevent bleeding after endoscopic papillectomy.METHODS:
Patients (nâ=â80) with suspected benign adenomas on the major papilla who were scheduled for endoscopic papillectomy with or without clipping were randomized. A new duodenoscope-compatible clip capable of being rotated, reopened, and repeatedly repositioned was used. The primary end point was incidence of delayed bleeding.RESULTS:
The clipping procedure was successful in all patients. The incidence of delayed bleeding was nonsignificantly higher in the no-clipping group than in the clipping group (31.6â% [95â% confidence interval (CI) 19.1-47.5] vs. 15.0â% [95â%CI 7.1-29.1]). The incidence of post-endoscopic retrograde cholangiopancreatography pancreatitis did not differ significantly between the groups (clipping vs. no-clipping 17.5â% [95â%CI 8.7-31.9] vs. 5.3â% [95â%CI 1.5-17.3]), and all cases were mild.CONCLUSIONS:
Placement of the newly designed rotatable clip was technically feasible and tended to have a protective effect by preventing delayed bleeding after endoscopic papillectomy, although statistical significance was not reached.
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Neoplasias Pancreáticas
/
Ampolla Hepatopancreática
/
Neoplasias del Conducto Colédoco
/
Neoplasias Duodenales
Tipo de estudio:
Clinical_trials
Límite:
Humans
Idioma:
En
Revista:
Endoscopy
Año:
2022
Tipo del documento:
Article