Efficacy of Prophylactic Epinephrine Solution Injection in Prevention of Delayed Post-sphincterotomy
Efficacy of Prophylactic Epinephrine Solution Injection in Prevention of Delayed Post-sphincterotomy Bleeding in Patients with Transient Bleeding During ERCP
Wen-Hsin Huang
400 participants
Jul 15, 2021
INTERVENTIONAL
Conditions
Summary
Bleeding is the most frequently reported serious complication of endoscopic sphincterotomy, and severe bleeding has occurred in about 1% to 2% of patients. Endoscopic injection of epinephrine is the most commonly used, effective, and least expensive method for the management of post- sphincterotomy bleeding. However, the efficacy of prophylactic saline-epinephrine solution injection to prevent delayed EST bleeding when transient bleeding During ERCP has not been established.
Eligibility
Inclusion Criteria5
- Age 20 years or older.
- Ability to give informed consent.
- An naive major papilla.
- Transient bleeding after endoscopic sphincterotomy
- Bleeding less than 30 secs when end of procedure
Exclusion Criteria13
- Prior endoscopic sphincterotomy.
- Thrombocytopenia (platelets <50,000/mm3).
- Liver cirrhosis (Child A-C)
- CKD stage 4-5 and dialysis.
- Allergy to epinephrine
- Prolonged PT/APTT (INR>1.5)
- Had exposure any antithrombotic or antiplatelet agent in recent 7 days and/or will take those agents in one month after EST
- Ampulla Vater tumor
- Active GI bleeding
- Pregnancy
- Limited visibility when immediate bleeding after sphincterotomy
- Still bleeding after 30 secs when end of procedure
- Recurrent bleeding during ERCP
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Interventions
epinephrine solution injection at least 1 ml to the post- sphincterotomy wound
Locations(1)
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NCT04964869