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Efficacy analysis of hemostatic spray following endoscopic papillectomy: A multicenter comparative study

Authors
 Kyong Joo Lee  ;  Tae Hoon Lee  ;  Jae Hee Cho  ;  Jong Jin Hyun  ;  Sung Ill Jang  ;  Seok Jeong  ;  Jin-Seok Park  ;  Jae Kook Yang  ;  Don Haeng Lee  ;  Dong Ki Lee  ;  Sang Heum Park 
Citation
 JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Vol.37(11) : 2138-2144, 2022-11 
Journal Title
JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY
ISSN
 0815-9319 
Issue Date
2022-11
MeSH
Argon Plasma Coagulation ; Endoscopy ; Epinephrine ; Hemostatics* ; Humans ; Pancreatitis* / epidemiology ; Treatment Outcome
Keywords
bleeding ; delayed bleeding rate ; endoscopic papillectomy ; hemostatic spray ; prophylaxis
Abstract
Background and aim: Endoscopic post-papillectomy bleeding is a serious adverse event with a prevalence ranging from 2% to 45.3%. Conventional hemostatic methods, including diluted epinephrine injection before papillectomy or argon plasma coagulation after papillectomy, did not show a preventive role in reducing immediate or delayed post-papillectomy bleeding. Therefore, we aimed to assess the efficacy and safety of a hemostatic powder spray for post-papillectomy bleeding and compare with those of conventional modalities.

Methods: Patients who underwent endoscopic papillectomy were enrolled in five tertiary hospitals. The group was divided into hemostatic spray and conventional control groups according to the bleeding control methods. The main outcome measurements were delayed bleeding rate and any adverse events related to the procedures.

Results: A total of 40 patients who received a hemostatic spray (n = 18) or conventional hemostatic methods (n = 22) after endoscopic papillectomy were included. The prevalence of delayed bleeding was not different in the two groups: 27.8% and 36.4% in hemostatic spray and conventional control groups (P = 0.564), respectively. The adverse events such as post-papillectomy pancreatitis and cholangitis were not different in the two groups. There were no procedure-related mortalities.

Conclusion: Hemostatic spray is technically feasible and safe for the prevention or management of post-papillectomy bleeding. Hemostatic spray can be one of the options for post-papillectomy bleeding control methods owing to its convenient use.
Full Text
https://onlinelibrary.wiley.com/doi/10.1111/jgh.16004
DOI
10.1111/jgh.16004
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Lee, Dong Ki(이동기) ORCID logo https://orcid.org/0000-0002-0048-9112
Jang, Sung Ill(장성일) ORCID logo https://orcid.org/0000-0003-4937-6167
Cho, Jae Hee(조재희) ORCID logo https://orcid.org/0000-0003-4174-0091
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/192788
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