Predictors of re-bleeding after endoscopic hemostasis for delayed post-endoscopic sphincterotomy bleeding

Lee, Mu-Hsien; Tsou, Yung-Kuan; Lin, Cheng–Hui; Lee, Ching‐Song; Liu, Nai‐Jen; Sung, Kai-Feng; Cheng, Hao‐Tsai

doi:10.3748/wjg.v22.i11.3196

Cited by 24 publications

(18 citation statements)

References 27 publications

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“…[23] Endoscopic hemostasis is currently the first choice of treatment for post-ERCP bleeding, whereas angiography or surgery can serve as alternative rescue management if endoscopic hemostasis fails to stop the hemorrhage. [24] Therefore, we chose the recording of a of post-ERCP endoscopic hemostasis procedure in the NHIRD as a surrogate marker for post-EST or post-EPBD major bleeding events.…”

Section: Discussionmentioning

confidence: 99%

Major bleeding risk of endoscopic sphincterotomy versus endoscopic papillary balloon dilatation in hemodialysis patients

Tsai

Wang

Yang

et al. 2019

Saudi J Gastroenterol

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Background/Aims: Endoscopic sphincterotomy (EST) and endoscopic papillary balloon dilatation (EPBD) are used for therapeutic endoscopic retrograde cholangiopancreatography (ERCP). The postprocedure bleeding rate for EPBD is low in the normal population; however, this bleeding rate in a group of patients prone to bleeding, such as patients with end-stage renal disease, is not well-established. We therefore evaluated the post-EST and post-EPBD bleeding rate among hemodialysis (HD) patients based on data from Taiwan's National Health Insurance Research Database (NHIRD). Patients and Methods: The NHIRD entries for a population of 2 million were screened for patients who had a catastrophic illness card for HD between 1 st January 2004 and 31 st December 2011 and these patients were enrolled as research subjects. The rates of major gastrointestinal tract bleeding events appearing within 14 days after EST or EPBD were compared between HD and non-HD patients. Results: A total of 3561 patients, over 18 years of age and without liver cirrhosis or hematologic diseases, underwent 3826 EST and 280 EPBD procedures during the 8 calendar years selected for our analysis. The total post-ERCP major bleeding rate was much higher in HD than in non-HD patients (8.64% vs. 2.16%, P < 0.0001). The rate of postprocedure major bleeding events was lower for non-HD patients who underwent EPBD than those who underwent EST (0.75% vs. 2.26%; P = 0.049), whereas the postprocedure major bleeding event rates were similar in HD patients who underwent either EPBD or EST (8.70% vs. 8.33%; P = 0.484). Conclusion: Post-ERCP, post-EST, and post-EPBD major bleeding rates were all higher in HD patients in this study. EPBD resulted in lower postprocedure major bleeding events than EST in the non-HD population, but it failed to provide the reduction in bleeding events needed to perform endoscopic hemostasis in HD patients.

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Section: Discussionmentioning

confidence: 99%

Major bleeding risk of endoscopic sphincterotomy versus endoscopic papillary balloon dilatation in hemodialysis patients

Tsai

Wang

Yang

et al. 2019

Saudi J Gastroenterol

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“…In this study, immediate bleeding in three of 13 patients was aborted using only epinephrine spray only and 10 patients required further endoscopic hemostasis by epinephrine injection. Past studies have shown that rebleeding after initially successful endoscopic hemostasis for EST bleeding is as high as 21.7%, and the severity of the initial bleeding and a high serum bilirubin of more than 10 mg/dL are predictors of rebleeding.…”

Section: Discussionmentioning

confidence: 99%

Prevention of post‐sphincterotomy bleeding by proton pump inhibitor: A randomized controlled trial

Leung

But

Wong

et al. 2018

J of Digest Diseases

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“…There is a reduction of vitamin K absorption due to cholestasis condition and the patients might have the hemorrhagic diathesis [9,10]. To our knowledge, there are only two previous studies showing that high bilirubin level is an independent risk factor in obstructive jaundice patients who underwent intervention procedures; however in one study the sample size was too small and in another study patients with decompensated liver cirrhosis and the use of anti-platelet before sphincterotomy were included [11,12]. In our study the population is more homogenous and it might be the reason of different finding.…”

Section: Discussionmentioning

confidence: 99%

Hyperbilirubinemia as a Post-Sphincterotomy Bleeding Risk during Endoscopic Retrograde Cholangio-Pancreatography (ERCP) Procedure in Normal Hemostasis Profile Patients

Lesmana¹

2016

JGPLD

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Predictors of re-bleeding after endoscopic hemostasis for delayed post-endoscopic sphincterotomy bleeding

Abstract: Re-bleeding occurs in approximately one-fifth of patients after initial successful endoscopic hemostasis for delayed post-ES bleeding. Severity of initial bleeding and serum bilirubin level of greater than 10 mg/dL are predictors of re-bleeding.

Cited by 24 publications

References 27 publications

Major bleeding risk of endoscopic sphincterotomy versus endoscopic papillary balloon dilatation in hemodialysis patients

Major bleeding risk of endoscopic sphincterotomy versus endoscopic papillary balloon dilatation in hemodialysis patients

Prevention of post‐sphincterotomy bleeding by proton pump inhibitor: A randomized controlled trial

Hyperbilirubinemia as a Post-Sphincterotomy Bleeding Risk during Endoscopic Retrograde Cholangio-Pancreatography (ERCP) Procedure in Normal Hemostasis Profile Patients

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