Endoscopic sphincterotomy complications and their management: an attempt at consensus

Cotton, Peter B.; Lehman, Glen A.; Vennes, Jack A.; Geenen, Joseph E.; Russell, R. C. G.; Meyers, William C.; Liguory, C; Nickl, Nicholas

doi:10.1016/s0016-5107(91)70740-2

Cited by 2,560 publications

(1,981 citation statements)

References 64 publications

Supporting

Mentioning

1,794

Contrasting

Unclassified

Order By: Relevance

“…Two patients had a small perforation at the stricture site (graded as a mild complication) and one patient developed moderately severe pancreatitis. 9 No sphincterotomy had been performed in these patients.…”

Section: Resultsmentioning

confidence: 95%

Lack of complications following short-term stent therapy for extrahepatic bile duct strictures in primary sclerosing cholangitis

Wit¹,

Rauws²,

Bracht³

et al. 1997

Gastrointestinal Endoscopy

View full text Add to dashboard Cite

General rightsIt is not permitted to download or to forward/distribute the text or part of it without the consent of the author(s) and/or copyright holder(s), other than for strictly personal, individual use, unless the work is under an open content license (like Creative Commons). Disclaimer/Complaints regulationsIf you believe that digital publication of certain material infringes any of your rights or (privacy) interests, please let the Library know, stating your reasons. In case of a legitimate complaint, the Library will make the material inaccessible and/or remove it from the website. Please Ask the Library: http://uba.uva.nl/en/contact, or a letter to: Library of the University of Amsterdam, Secretariat, Singel 425, 1012 WP Amsterdam, The Netherlands. You will be contacted as soon as possible.

show abstract

Section: Resultsmentioning

confidence: 95%

Lack of complications following short-term stent therapy for extrahepatic bile duct strictures in primary sclerosing cholangitis

Wit¹,

Rauws²,

Bracht³

et al. 1997

Gastrointestinal Endoscopy

View full text Add to dashboard Cite

show abstract

“…Difficult-to-control post-ES bleeding was defined as a hemorrhage where usual endoscopic measures [8,15,16] were attempted but failed to achieve hemostasis. Immediate post-ES bleeding episodes were defined as episodes that occurred at the time of sphincterotomy [8,15], while delayed post-ES bleeding episodes were defined as bleeding that began hours to several days after the end of the ERCP procedure [8,16].…”

Section: Definitionsmentioning

confidence: 99%

“…Immediate post-ES bleeding episodes were defined as episodes that occurred at the time of sphincterotomy [8,15], while delayed post-ES bleeding episodes were defined as bleeding that began hours to several days after the end of the ERCP procedure [8,16]. Bleeding severity was graded as mild, moderate or severe using the following previously described validated grading system [16]: Mild bleeding was defined by clinical evidence of gastrointestinal bleeding, hemoglobin decrease of less than 3 g/dl, and no need for transfusion, while moderate bleeding was defined by the need for transfusion (4 units or less); severe bleeding was defined by the need for transfusion (5 units or more) or rescue intervention (angiographic or surgical). Immediate post-ES bleeding that required endoscopic treatment was considered, at minimum, as mild bleeding.…”

Section: Definitionsmentioning

confidence: 99%

“…Late complications were defined as those complications that occurred after FCSEMS removal. Migration (distal or proximal), pancreatitis, cholecystitis, bile duct and duodenal ulcerations, de novo choledocholithiasis, and late strictures were carefully monitored using previously defined definitions [16,20,23,25,27].…”

Section: Definitionsmentioning

confidence: 99%

“…The incidence of post-ES bleeding varies from 0.76-2 to 10-48 % [8,15], depending on the definition applied. Post-ES bleeding is classified as immediate or delayed according to the time of presentation [8,15,16], and it is associated with increased morbidity and mortality [8,9,17]. Endoscopic treatments include injection treatment, thermal therapy, endoclips, and balloon tamponade, which can be applied individually or in combined treatments.…”

mentioning

confidence: 99%

See 2 more Smart Citations

Short-term stenting using fully covered self-expandable metal stents for treatment of refractory biliary leaks, postsphincterotomy bleeding, and perforations

Canena

Liberato²,

Horta

et al. 2012

Surg Endosc

View full text Add to dashboard Cite

Background Fully covered self-expandable metal stents (FCSEMS) have been used as a rescue therapy for several benign biliary tract conditions (BBC). Long-term stent placement commonly occurs, and prolonged FCSEMS placement is associated with the majority of the complications reported. This study evaluated the duration of stenting and the efficacy and safety of temporary FCSEMS placement for three BBCs: refractory biliary leaks, postsphincterotomy bleeding, and perforations. Methods This was a retrospective case series with longterm follow-up of 25 patients who underwent FCSEMS placement for BBCs. This study included 17 patients with postcholecystectomy refractory biliary leaks who had previously undergone unsuccessful sphincterotomy and plastic stent placement, 4 patients with difficult-to-control postsphincterotomy bleeding, and 4 patients with a perforation following endoscopic sphincterotomy. Stents were removed according to clinical evidence of problem resolution. The review included stenting duration, safe FCSEMS removal, clinical efficacy, complications, and long-term outcomes. During the follow-up period, ERCP and cholangioscopy procedures were performed to exclude the possibility of bile duct lesion development. Results Complete resolution of the initial condition was achieved in all patients. Patients with biliary leaks had a median stent duration time of 16 days (range 7-28 days). Patients with bleeding had stents removed after a median time of 6 days (range 3-15 days). Patients with perforations had their stents removed after a median time of 29.5 days (range 21-30 days). There were no complications related to stenting. Conclusions Temporary placement of a FCSEMS for 30 days or less is an effective rescue therapy for refractory biliary leaks, difficult-to-control post-endoscopic sphincterotomy bleeding, and perforations. Duration of stenting should be different for each type of condition. Stents can be safely removed, and short-term stenting is associated with the absence of early and late complications.

show abstract

Validity of Clinical Criteria in the Management of Endoscopic Retrograde Cholangiopancreatography–Related Duodenal Perforations

Assalia

Suissa²,

Ilivitzki³

et al. 2007

Arch Surg

View full text Add to dashboard Cite

show abstract

Endoscopic sphincterotomy complications and their management: an attempt at consensus

Cited by 2,560 publications

References 64 publications

Lack of complications following short-term stent therapy for extrahepatic bile duct strictures in primary sclerosing cholangitis

Lack of complications following short-term stent therapy for extrahepatic bile duct strictures in primary sclerosing cholangitis

Short-term stenting using fully covered self-expandable metal stents for treatment of refractory biliary leaks, postsphincterotomy bleeding, and perforations

Validity of Clinical Criteria in the Management of Endoscopic Retrograde Cholangiopancreatography–Related Duodenal Perforations

Contact Info

Product

Resources

About