Bleeding patterns following endoscopic sphincterotomy (ES) and the value of these to predict subsequent bleeding are poorly understood.
The efficacy and side effects of epinephrine injection for persistent bleeding are also unclear.
In this study, 506 patients undergoing ES were prospectively assessed and followed-up.
The team recorded the character of bleeding, immediately, 5 minutes following ES and on the completion of the procedure.
Any patients with persistent bleeding were given epinephrine injection(s) into the bleeding point with a sclerotherapy needle.
The research team determined the bleeding patterns immediately following ES: 6% pulsatile, 42% oozing, 27% trickle, and 24% none.
|Epinephrine was injected during 14% of the procedures.|
|American Journal of Gastroenterology|
Epinephrine was injected during 14% of the procedures. The researchers did not identify complications or delayed bleeding.
They established that the only variable associated with bleeding after ES was abnormal labs.
Dr Mel Wilcox's team concluded, "The pattern of bleeding following ES may not predict the risk of late bleeding".
"Abnormal labs are associated with visible bleeding".
"Epinephrine injection is safe and appears to provide effective hemostasis".