Temporary self-expandable metal stent placement for treatment of post-sphincterotomy bleeding.
BACKGROUND
Endoscopic sphincterotomy (ES) is a basic technique for performing therapeutic interventions during ERCP. Bleeding after ES is a recognized complication and can be difficult to treat.


OBJECTIVE
To evaluate the role of temporary placement of fully covered self-expandable metal stents (SEMSs) for the treatment of difficult-to-control post-ES hemorrhage.


METHODS
Retrospective case series.


METHODS
Interventional endoscopy unit at a tertiary care referral hospital.


METHODS
Five patients treated with temporary SEMSs for difficult-to-control post-ES hemorrhage.


METHODS
ERCP with placement of fully covered, biliary SEMSs and subsequent stent removal within 8 weeks.


METHODS
Technical success of SEMS placement, clinical success with hemostasis, complications related to SEMS placement and removal.


RESULTS
Five patients were treated with temporary fully covered SEMSs for post-ES hemorrhage over an 8-month period. Hemostasis was achieved in all patients. Within 8 weeks of the procedure, the SEMSs were easily removed in 3 patients; the SEMSs had spontaneously migrated without incident in the other 2. No other complications were seen.


CONCLUSIONS
Retrospective series with a small number of patients.


CONCLUSIONS
Temporary placement of fully covered SEMSs across the biliary orifice seems to be an effective treatment for post-ES hemorrhage. However, stent migration is a concern and may limit this therapy in certain settings.
Interventional Endoscopy Services, California Pacific Medical Center, San Francisco, California 94115, USA.
Janak N
JN
Shah
Fernando
F
Marson
Kenneth F
KF
Binmoeller
D000368:Aged; D000369:Aged, 80 and over; D002760:Cholangiopancreatography, Endoscopic Retrograde; D020878:Device Removal; D005260:Female; D006488:Hemostasis, Surgical / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019106:Postoperative Hemorrhage / Q000628:therapy*; D011474:Prosthesis Design; D012189:Retrospective Studies; D016717:Sphincterotomy, Endoscopic; D015607:Stents; D055815:Young Adult