Treating delayed endoscopic sphincterotomy-induced bleeding: epinephrine injection with or without thermotherapy.
World J Gastroenterol
; 15(38): 4823-8, 2009 Oct 14.
Article
em En
| MEDLINE
| ID: mdl-19824118
ABSTRACT
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.
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Epinefrina
/
Colangiopancreatografia Retrógrada Endoscópica
/
Esfinterotomia Endoscópica
/
Hipertermia Induzida
Tipo de estudo:
Observational_studies
Idioma:
En
Revista:
World J Gastroenterol
Ano de publicação:
2009
Tipo de documento:
Article