Early Covered Self-Expandable Metal Stent Placement Is Effective for Massive Post-endoscopic Sphincterotomy Bleeding
- PDF / 1,084,075 Bytes
- 8 Pages / 595.276 x 790.866 pts Page_size
- 78 Downloads / 205 Views
ORIGINAL ARTICLE
Early Covered Self‑Expandable Metal Stent Placement Is Effective for Massive Post‑endoscopic Sphincterotomy Bleeding Tadahisa Inoue1 · Mayu Ibusuki1 · Rena Kitano1 · Yuji Kobayashi1 · Tomohiko Ohashi1 · Yukiomi Nakade1 · Yoshio Sumida1 · Kiyoaki Ito1 · Masashi Yoneda1 Received: 8 November 2019 / Accepted: 7 January 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Background Placement of covered self-expandable metallic stent (CSEMS) for post-endoscopic sphincterotomy (ES) bleeding achieves excellent hemostasis results. Although CSEMS placement is typically performed after failure of conventional endoscopic combination therapy, its excellent outcomes may justify earlier placement. Aims We aimed to examine the efficacy of “early” CSEMS placement for massive post-ES bleeding. Methods The medical records of 2750 patients who underwent ES between 2005 and 2019 were reviewed retrospectively, and 61 patients who developed massive post-ES bleeding were enrolled. These patients were divided into those who underwent early CSEMS placement (E-CSEMS group) and those who underwent conventional endoscopic combination therapy (Conventional group). The outcomes of hemostasis procedures were compared between the groups. Results The primary success rates of endoscopic hemostasis were 100% (21/21) and 98% (39/40) in the E-CSEMS group and Conventional group, respectively, without significant differences (P = 1.000). However, in the E-CSEMS group, rebleeding was significantly less frequent (5% vs. 31%; P = 0.023), the median hemostasis procedure time was significantly shorter (14 min vs. 26 min; P 10 nights, or an intensive care unit stay of > 1 day. If post-ES bleeding did not correspond to any of these, it was defined as mild bleeding.
Statistical Analyses The differences between categorical variables were evaluated using Fisher’s exact test. The continuous variables were compared using the Mann–Whitney U test. To determine the predictive factors for re-bleeding, multivariate analysis was performed using logistic regression of variables with values of P
Data Loading...
