Endocut Versus Conventional Blended Electrosurgical Current for Endoscopic Biliary Sphincterotomy: A Meta-Analysis of Complications

Li, Defeng; Yang, Meifeng; Chang, Xin; Wang, Nannan; Tan, Fang‐Fang; Xie, Haina; Xue, Fang; Wang, Shuling; Fan, Wei; Wang, Jianyao; Yu, Zhichao; Wei, Cheng; Xiong, Feng; Liu, Tingting; Luo, Ming‐Han; Wang, Lisheng; Li, Zhao‐Shen; Yao, Jun

doi:10.1007/s10620-019-05513-w

Cited by 19 publications

(13 citation statements)

References 28 publications

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“…With respect to the technique of endoscopic sphincterotomy, an in vitro dissection study concluded that the papilla should be incised in the 10 -11 oʼclock region because this contains only 10 % of all papillary arteries [57]. Blended current, as opposed to pure cutting current, is recommended as it reduces the incidence of bleeding without increasing the risk of PEP [58,59]; a meta-analysis (3 RCTs, 594 patients) suggested that bleeding was less frequent when Endocut was used compared to other blended current modes but this is of doubtful clinical significance as all bleeding was minor [60].…”

Section: Risk Factors For Post-sphincterotomy Bleedingmentioning

confidence: 99%

ERCP-related adverse events: European Society of Gastrointestinal Endoscopy (ESGE) Guideline

et al. 2019

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Main Recommendations Prophylaxis 1 ESGE recommends routine rectal administration of 100 mg of diclofenac or indomethacin immediately before endoscopic retrograde cholangiopancreatography (ERCP) in all patients without contraindications to nonsteroidal anti-inflammatory drug administration.Strong recommendation, moderate quality evidence. 2 ESGE recommends prophylactic pancreatic stenting in selected patients at high risk for post-ERCP pancreatitis (inadvertent guidewire insertion/opacification of the pancreatic duct, double-guidewire cannulation).Strong recommendation, moderate quality evidence. 3 ESGE suggests against routine endoscopic biliary sphincterotomy before the insertion of a single plastic stent or an uncovered/partially covered self-expandable metal stent for relief of biliary obstruction.Weak recommendation, moderate quality evidence. 4 ESGE recommends against the routine use of antibiotic prophylaxis before ERCP.Strong recommendation, moderate quality evidence. 5 ESGE suggests antibiotic prophylaxis before ERCP in the case of anticipated incomplete biliary drainage, for severely immunocompromised patients, and when performing cholangioscopy.Weak recommendation, moderate quality evidence. 6 ESGE suggests tests of coagulation are not routinely required prior to ERCP for patients who are not on anticoagulants and not jaundiced.Weak recommendation, low quality evidence. Treatment 7 ESGE suggests against salvage pancreatic stenting in patients with post-ERCP pancreatitis.Weak recommendation, low quality evidence. 8 ESGE suggests temporary placement of a biliary fully covered self-expandable metal stent for post-sphincterotomy bleeding refractory to standard hemostatic modalities.Weak recommendation, low quality evidence. 9 ESGE suggests to evaluate patients with post-ERCP cholangitis by abdominal ultrasonography or computed tomography (CT) scan and, in the absence of improvement with conservative therapy, to consider repeat ERCP. A bile sample should be collected for microbiological examination during repeat ERCP.Weak recommendation, low quality evidence.

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Section: Risk Factors For Post-sphincterotomy Bleedingmentioning

confidence: 99%

ERCP-related adverse events: European Society of Gastrointestinal Endoscopy (ESGE) Guideline

et al. 2019

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“…104 There are a number of measures which can reduce the risk of haemorrhage at ERCP including avoidance of sphincterotomy prior to biliary stenting, 105 and use of a blended current rather than pure-cutting current. [106][107][108] These, and other measures to reduce the risk of haemorrhage are discussed in previous ESGE guidelines. 104 105 Two uncontrolled retrospective studies reported postendoscopic sphincterotomy (ES) bleeding in 8 (19%) of 43 patients under antiplatelet monotherapy or dual therapy, including only one significant episode of haemorrhage.…”

Section: Endoscopic Retrograde Cholangiopancreatographymentioning

confidence: 99%

Endoscopy in patients on antiplatelet or anticoagulant therapy: British Society of Gastroenterology (BSG) and European Society of Gastrointestinal Endoscopy (ESGE) guideline update

Veitch

Radaelli

Alikhan

et al. 2021

Gut

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This is a collaboration between the British Society of Gastroenterology (BSG) and the European Society of Gastrointestinal Endoscopy (ESGE), and is a scheduled update of their 2016 guideline on endoscopy in patients on antiplatelet or anticoagulant therapy. The guideline development committee included representatives from the British Society of Haematology, the British Cardiovascular Intervention Society, and two patient representatives from the charities Anticoagulation UK and Thrombosis UK, as well as gastroenterologists. The process conformed to AGREE II principles and the quality of evidence and strength of recommendations were derived using GRADE methodology. Prior to submission for publication, consultation was made with all member societies of ESGE, including BSG. Evidence-based revisions have been made to the risk categories for endoscopic procedures, and to the categories for risks of thrombosis. In particular a more detailed risk analysis for atrial fibrillation has been employed, and the recommendations for direct oral anticoagulants have been strengthened in light of trial data published since the previous version. A section has been added on the management of patients presenting with acute GI haemorrhage. Important patient considerations are highlighted. Recommendations are based on the risk balance between thrombosis and haemorrhage in given situations.

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“…An ESGE guideline on ERCP-related adverse events has suggested that patients should be considered to be at increased risk for post-sphincterotomy haemorrhage if at least one of the following factors is present: anticoagulant intake, platelet count < 50,000 /mm 3 , cirrhosis, dialysis for end-stage renal disease, intraprocedural bleeding and low endoscopist experience 104 . There are a number of measures which can reduce the risk of haemorrhage at ERCP including avoidance of sphincterotomy prior to biliary stenting 105 , and use of a blended current rather than pure-cutting current 106 107 108 . These, and other measures to reduce the risk of haemorrhage are discussed in previous ESGE guidelines 104 105 .…”

Section: Endoscopic Proceduresmentioning

confidence: 99%

Endoscopy in patients on antiplatelet or anticoagulant therapy: British Society of Gastroenterology (BSG) and European Society of Gastrointestinal Endoscopy (ESGE) guideline update

et al. 2021

View full text Add to dashboard Cite

This is a collaboration between the British Society of Gastroenterology (BSG) and the European Society of Gastrointestinal Endoscopy (ESGE), and is a scheduled update of their 2016 guideline on endoscopy in patients on antiplatelet or anticoagulant therapy. The guideline development committee included representatives from the British Society of Haematology, the British Cardiovascular Intervention Society, and two patient representatives from the charities Anticoagulation UK and Thrombosis UK, as well as gastroenterologists. The process conformed to AGREE II principles, and the quality of evidence and strength of recommendations were derived using GRADE methodology. Prior to submission for publication, consultation was made with all member societies of ESGE, including BSG. Evidence-based revisions have been made to the risk categories for endoscopic procedures, and to the categories for risks of thrombosis. In particular a more detailed risk analysis for atrial fibrillation has been employed, and the recommendations for direct oral anticoagulants have been strengthened in light of trial data published since the previous version. A section has been added on the management of patients presenting with acute GI haemorrhage. Important patient considerations are highlighted. Recommendations are based on the risk balance between thrombosis and haemorrhage in given situations.

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Endocut Versus Conventional Blended Electrosurgical Current for Endoscopic Biliary Sphincterotomy: A Meta-Analysis of Complications

Cited by 19 publications

References 28 publications

ERCP-related adverse events: European Society of Gastrointestinal Endoscopy (ESGE) Guideline

ERCP-related adverse events: European Society of Gastrointestinal Endoscopy (ESGE) Guideline

Endoscopy in patients on antiplatelet or anticoagulant therapy: British Society of Gastroenterology (BSG) and European Society of Gastrointestinal Endoscopy (ESGE) guideline update

Endoscopy in patients on antiplatelet or anticoagulant therapy: British Society of Gastroenterology (BSG) and European Society of Gastrointestinal Endoscopy (ESGE) guideline update

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