Post-sphincterotomy bleeding after the introduction of microprocessor-controlled electrosurgery: does the new technology make the difference?
BACKGROUND
Bleeding as a complication of endoscopic sphincterotomy is influenced by several factors. The objective of this study was to compare rates of bleeding after sphincterotomy performed with two different electrosurgical current generators (Valleylab SSE2L and ERBE ICC200).


METHODS
A total of 6179 consecutive reports of ERCP were analyzed to compare the frequency of endoscopically and clinically evident bleeding after sphincterotomy when using the Valleylab SSE2L generator (from February 1994 to November 1997) and the ERBE ICC200 generator (from December 1997 to September 2000). Relevant risk factors were assessed by univariate analysis and significant predictors were included in a multiple logistic regression model.


RESULTS
A total of 2711 sphincterotomies were performed in 2309 patients (1749 biliary, 962 pancreatic). Endoscopically observed bleeding occurred in 68 patients (5.5%) in the ValleyLab group and 13 (1.2%) in the ERBE group. The ValleyLab generator was independently associated with an increase in endoscopically observed bleeding (OR 4.02: 95% CI[2.13, 7.61], p <0.001). There was no significant difference in clinically evident bleeding between the two groups.


CONCLUSIONS
Use of the microprocessor-controlled ERBE electrosurgical generator for endoscopic sphincterotomy was associated with a significantly lower frequency of endoscopically observed bleeding but not clinically evident bleeding.
Perini
Rafael F
RF
Charleston, South Carolina, USA.
Sadurski
Rafal
R
Cotton
Peter B
PB
Patel
Rig S
RS
Hawes
Robert H
RH
Cunningham
John T
JT
D000328:Adult; D000368:Aged; D011211:Electric Power Supplies; D004598:Electrosurgery / Q000009:adverse effects / Q000295:instrumentation*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology*; D006801:Humans; D008297:Male; D008838:Microcomputers; D008875:Middle Aged; D010179:Pancreas / Q000293:injuries; D010195:Pancreatitis / Q000209:etiology; D019106:Postoperative Hemorrhage / Q000209:etiology*; D012189:Retrospective Studies; D016717:Sphincterotomy, Endoscopic / Q000009:adverse effects* / Q000295:instrumentation*