Treating delayed endoscopic sphincterotomy-induced bleeding: Epinephrine injection with or without thermotherapy

Yung Kuan Tsou, Cheng Hui Lin, Nai Jen Liu, Jui-Hsiang Tang, Kai Feng Sung, Chi Liang Cheng, Ching Song Lee

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

AIM: To compare the hemostatic efficacy between epinephrine injection alone and epinephrine injection combined with thermotherapy for delayed postendoscopic sphincterotomy (ES) bleeding. METHODS: Cases with delayed post-ES bleeding undergoing epinephrine injection alone (epinephrine injection group, n = 26) or epinephrine combined with thermotherapy (combination therapy group, n = 33) in our institution between 1999 and 2007 were retrospectively investigated. The main outcome measurements were: initial endoscopic hemostasis, rebleeding, complications, requirement of angiographic embolization or surgery, requirement for blood transfusion, and mortality. RESULTS: The initial hemostatic efficacy was 96.2% for epinephrine injection alone and 100% for combination therapy (P = 0.44). There were four patients with re-bleeding in each group (16.0% vs 12.1%, P = 0.72). There was only one complication of pancreatitis from the combination therapy group. Three patients (11.5%) in the epinephrine injection group and one patient (3%) in the combination therapy group required angiographic embolization or surgery (P = 0.31). The total number of blood transfusions was not significantly different between the two groups (3.5 ± 4.6 U vs 3.5 ± 4.5 U, P = 0.94). There was no bleeding-related death in either group. CONCLUSION: Epinephrine injection alone is as effective as epinephrine injection combined with thermotherapy for the management of delayed post-ES bleeding.

Original languageEnglish
Pages (from-to)4823-4828
Number of pages6
JournalWorld Journal of Gastroenterology
Volume15
Issue number38
DOIs
Publication statusPublished - Dec 1 2009
Externally publishedYes

Fingerprint

Endoscopic Sphincterotomy
Induced Hyperthermia
Epinephrine
Hemorrhage
Injections
Group Psychotherapy
Hemostatics
Blood Transfusion
Endoscopic Hemostasis
Pancreatitis

Keywords

  • Bleeding
  • Endoscopic retrograde cholangiopancreatography
  • Endoscopic sphincterotomy
  • Epinephrine
  • Thermotherapy

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Treating delayed endoscopic sphincterotomy-induced bleeding : Epinephrine injection with or without thermotherapy. / Tsou, Yung Kuan; Lin, Cheng Hui; Liu, Nai Jen; Tang, Jui-Hsiang; Sung, Kai Feng; Cheng, Chi Liang; Lee, Ching Song.

In: World Journal of Gastroenterology, Vol. 15, No. 38, 01.12.2009, p. 4823-4828.

Research output: Contribution to journalArticle

Tsou, Yung Kuan ; Lin, Cheng Hui ; Liu, Nai Jen ; Tang, Jui-Hsiang ; Sung, Kai Feng ; Cheng, Chi Liang ; Lee, Ching Song. / Treating delayed endoscopic sphincterotomy-induced bleeding : Epinephrine injection with or without thermotherapy. In: World Journal of Gastroenterology. 2009 ; Vol. 15, No. 38. pp. 4823-4828.
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abstract = "AIM: To compare the hemostatic efficacy between epinephrine injection alone and epinephrine injection combined with thermotherapy for delayed postendoscopic sphincterotomy (ES) bleeding. METHODS: Cases with delayed post-ES bleeding undergoing epinephrine injection alone (epinephrine injection group, n = 26) or epinephrine combined with thermotherapy (combination therapy group, n = 33) in our institution between 1999 and 2007 were retrospectively investigated. The main outcome measurements were: initial endoscopic hemostasis, rebleeding, complications, requirement of angiographic embolization or surgery, requirement for blood transfusion, and mortality. RESULTS: The initial hemostatic efficacy was 96.2{\%} for epinephrine injection alone and 100{\%} for combination therapy (P = 0.44). There were four patients with re-bleeding in each group (16.0{\%} vs 12.1{\%}, P = 0.72). There was only one complication of pancreatitis from the combination therapy group. Three patients (11.5{\%}) in the epinephrine injection group and one patient (3{\%}) in the combination therapy group required angiographic embolization or surgery (P = 0.31). The total number of blood transfusions was not significantly different between the two groups (3.5 ± 4.6 U vs 3.5 ± 4.5 U, P = 0.94). There was no bleeding-related death in either group. CONCLUSION: Epinephrine injection alone is as effective as epinephrine injection combined with thermotherapy for the management of delayed post-ES bleeding.",
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N2 - AIM: To compare the hemostatic efficacy between epinephrine injection alone and epinephrine injection combined with thermotherapy for delayed postendoscopic sphincterotomy (ES) bleeding. METHODS: Cases with delayed post-ES bleeding undergoing epinephrine injection alone (epinephrine injection group, n = 26) or epinephrine combined with thermotherapy (combination therapy group, n = 33) in our institution between 1999 and 2007 were retrospectively investigated. The main outcome measurements were: initial endoscopic hemostasis, rebleeding, complications, requirement of angiographic embolization or surgery, requirement for blood transfusion, and mortality. RESULTS: The initial hemostatic efficacy was 96.2% for epinephrine injection alone and 100% for combination therapy (P = 0.44). There were four patients with re-bleeding in each group (16.0% vs 12.1%, P = 0.72). There was only one complication of pancreatitis from the combination therapy group. Three patients (11.5%) in the epinephrine injection group and one patient (3%) in the combination therapy group required angiographic embolization or surgery (P = 0.31). The total number of blood transfusions was not significantly different between the two groups (3.5 ± 4.6 U vs 3.5 ± 4.5 U, P = 0.94). There was no bleeding-related death in either group. CONCLUSION: Epinephrine injection alone is as effective as epinephrine injection combined with thermotherapy for the management of delayed post-ES bleeding.

AB - AIM: To compare the hemostatic efficacy between epinephrine injection alone and epinephrine injection combined with thermotherapy for delayed postendoscopic sphincterotomy (ES) bleeding. METHODS: Cases with delayed post-ES bleeding undergoing epinephrine injection alone (epinephrine injection group, n = 26) or epinephrine combined with thermotherapy (combination therapy group, n = 33) in our institution between 1999 and 2007 were retrospectively investigated. The main outcome measurements were: initial endoscopic hemostasis, rebleeding, complications, requirement of angiographic embolization or surgery, requirement for blood transfusion, and mortality. RESULTS: The initial hemostatic efficacy was 96.2% for epinephrine injection alone and 100% for combination therapy (P = 0.44). There were four patients with re-bleeding in each group (16.0% vs 12.1%, P = 0.72). There was only one complication of pancreatitis from the combination therapy group. Three patients (11.5%) in the epinephrine injection group and one patient (3%) in the combination therapy group required angiographic embolization or surgery (P = 0.31). The total number of blood transfusions was not significantly different between the two groups (3.5 ± 4.6 U vs 3.5 ± 4.5 U, P = 0.94). There was no bleeding-related death in either group. CONCLUSION: Epinephrine injection alone is as effective as epinephrine injection combined with thermotherapy for the management of delayed post-ES bleeding.

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