J Gastroenterol Hepatol Endosc | Volume 2, Issue 4 | Case Report | Open Access

Endoscopic Hemostasis of Post-Sphincterotomy Bleeding with Placement of Multiple Plastic Stents - 2 Cases Report

Hsien-Ping Lin^1* and Yu-Chiang Lin²

¹Division of Gastroenterology and Internal Medicine, Jen-Ai Hospital, Taichung, Taiwan
²Department of General Surgery, Jen-Ai Hospital, Taichung, Taiwan

^*Correspondance to: Hsien-Ping Lin 

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Abstract

It was not rare to have post-sphincterotomy bleeding (PSB) after endoscopic sphincterotomy (EST) in endoscopic retrograde cholangiopancreatography (ERCP). Severe PSB will be a challenge to treat endoscopically with traditional hemostasis methods. Some physicians had placed self-expandable fully-covered metallic stents (FCMS) to treat severe PSB with satisfactory results. We tried to place multiple plastic stents to make the similar tamponade effect as it did with FCMS. Two old female patients had severe delayed PSB after endoscopic sphincterotomy. Both could not have hemostasis after traditional injectional therapy with epinephrine. We then placed 3 plastic stents in one and 2 stents in the other patient and achieved immediate hemostasis without complication. Both of them had no recurrent bleeding during follow-up. The 2 patients had stents removed 2 weeks later respectively and had no sequela. Severe PSB may be treated effectively with multiple plastic stents placement as with FCMS

Keywords:

Post-sphincterotomy bleeding; Endoscopic sphincterotomy; Self-Expandable fullycovered metallic stents; Plastic stent

Citation:

Lin H-P, Lin Y-C. Endoscopic Hemostasis of Post-Sphincterotomy Bleeding with Placement of Multiple Plastic Stents - 2 Cases Report. J Gastroenterol Hepatol Endosc. 2017;2(4):1022.