Self-expandable metal stent placement for treatment of severe sphincterotomy bleeding

• Published in: Clinica terapeutica Vol. 164; no. 1; p. e27
• Main Authors: Zippi, M, De Felici, I, Pica, R, Agus, M A, Solinas, A, Occhigrossi, G, Traversa, G
• Format: Journal Article
• Language: English
• Published: Italy 2013
• Subjects: Aged, 80 and over; Blood Loss, Surgical; Cholangiopancreatography, Endoscopic Retrograde - methods; Choledocholithiasis - diagnostic imaging; Choledocholithiasis - surgery; Female; Humans; Metals; Sphincterotomy, Endoscopic - adverse effects; Stents; Treatment Outcome
• DOI: 10.7417/CT.2013.1517

One of the most frequent complications of endoscopic sphincterotomy (ES) is bleeding. When post-ES bleeding does not respond to the use of typical endoscopic therapy, the only alternative is angiography or surgery. A 82-year-old female was admitted for jaundice. A RMN-cholangiography revealed multiple stones in the common bile duct (CBD). She underwent endoscopic retrograde cholangiopancreatography (ERCP). The papilla major was located between two large periampullary diverticula. During the ES, a severe bleeding was observed from the upper part of the biliary cut. Several methods of hemostasis (injection of adrenaline, thermal methods and balloon tamponate) were performed without efficacy. A partially covered metallic stent was placed across the biliary orifice, in order to compress mechanically the bleeding site archiving the hemostasis.