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Treatment of Post Sphincterotomy-bleeding by Epinephrine-injection Versus Insertion of an Plastic Stent

Completed
Conditions
Endoscopic Biliary Sphincterotomy
Bleeding
Registration Number
NCT03725319
Lead Sponsor
Theresienkrankenhaus und St. Hedwig-Klinik GmbH
Brief Summary

Post sphinterotomy-bleeding (PSB) occurs in 1-2 % of Endosocpic Retrograde Cholangiopancreaticography (ERCP) and usually needs no blood transfusion after endoscopic therapy but can be life-threatening in some rare cases.

There are no prospective comparative studies concerning the endoscopic treatment of PSB due to the rarity of the incident.

Insertion of an endoprosthesis in the common bile duct may be more effective than Epinephrin-injection into the papilla which is the therapy of first choice.

A retrospective single centre analysis on both used methods over a study period of 16 years shall be performed.

Detailed Description

Post sphinterotomy-bleeding (PSB) occurs in 1-2 % of Endosocpic Retrograde Cholangiopancreaticography (ERCP) and usually needs no blood transfusion after endoscopic therapy but can be life-threatening in some rare cases.

The increasing use of antiplatelet and/or anticoagulant therapies enhances the risk of PSB.

There are no prospective comparative studies concerning the endoscopic treatment of PSB due to the rarity of the incident.

Insertion of an endoprosthesis in the common bile duct may be more effective than Epinephrin-injection into the papilla which is the therapy of first choice.

A retrospective single centre analysis on both used methods over a study period of 16 years shall be performed.

In detail, clinical success and safety of the procedure, re-bleeding rate, number of re-interventions and days of hospital stay will be analysed.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
100
Inclusion Criteria
  • Post sphincterotomy bleeding (PSB) of the papilla (time frame: from procedure up to ten days after the procedure)
  • Treatment of PSB by epinephrine-injection or insertion of a plastic stent into the common bile duct
Exclusion Criteria
  • Pregnant and/or lactating women
  • Complete patient record is not available

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Re-interventionsFrom the endoscopic treatment of post-sphincterotomy-bleeding up to three months

Amount of endoscopic re-interventions (further endoscopic therapy of re-bleeding of the papilla, removal or exchange of the plastic stent): number (n)

Clinical successFrom the successful endocopic treatment of post sphincterotomy-bleeding up to 30 days in the follow up

No re-bleeding occurs in the follow-up that requirers a further interventional treatment of re-bleeding (any endoscopic, radiological embolization or surgery): yes/no

Hospital stay after treatmentFrom the endoscopic treatment of post-sphincterotomy-bleeding up to 30 days

Hospital stay (days) after treatment of post sphincterotomy-bleeding

Secondary Outcome Measures
NameTimeMethod
Increasing of cholestasis parametersFrom treatment of post-sphincterotomy-bleeding up to three days

Any kind of cholestasis measured by an increase of bilirubin level (mg/dl) after the treatment of post-sphincterotomy-bleeding that can be refered to this treatment (patients with unsuccesful endoscopic drainage/stone extraction are excluded): yes/no

Post ERCP-pancreatitisFrom the endoscopic treatment of post-sphincterotomy-bleeding up to three days

Any kind of post ERCP-pancreatitis that occurs after treatment of post sphincterotomy-bleeding and can be refered to this treatment (patients with cannulated pancreatic duct are excluded): yes/no

Trial Locations

Locations (1)

Tertiary referral hospital: Theresienkrankenhaus und St. Hedwig Hospital, Academic

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Mannheim, Germany

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