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Medline ® Abstract for Reference 54

of 'Post-endoscopic retrograde cholangiopancreatography (ERCP) bleeding'

Partially covered vs uncovered sphincterotome and post-endoscopic sphincterotomy bleeding.
Katsinelos P, Paroutoglou G, Kountouras J, Chatzimavroudis G, Zavos C, Terzoudis S, Katsinelos T, Fasoulas K, Gelas G, Tzovaras G, Pilpilidis I
World J Gastroenterol. 2010;16(40):5077.
AIM: To prospectively compare partially covered vs uncovered sphincterotome use on post-endoscopic biliary sphincterotomy (ES) hemorrhage and other complications.
METHODS: All patients referred for therapeutic endoscopic retrograde cholangiopancreatography (ERCP) were randomly assigned to undergo ES either with a partially covered or an uncovered sphincterotome. Both patient and technical risk factors contributing to the development of post-ES bleeding were recorded and analyzed. The characteristics of bleeding was recorded during and after ES. Other complications were also compared.
RESULTS: Three-hundred and eighty-seven patients were recruited in this study; 194 patients underwent ES with a partially covered sphincterotome and 193 with conventional uncovered sphincterotome. No statistical difference was noted in the baseline characteristics and risk factors for post-ES induced hemorrhage between the 2 groups. No significant difference in the incidence and pattern of visible bleeding rates was found between the 2 groups (immediate bleeding in 24 patients with the partially covered sphincterotome vs 19 patients with the uncovered sphincterotome, P = 0.418). Delayed bleeding was observed in 2 patients with a partially covered sphincterotome and in 1 patient with an uncovered sphincterotome (P = 0.62). No statistical difference was noted in the rate of other complications.
CONCLUSION: The partially covered sphincterotome was not associated with a lower frequency of bleeding. Also, there was no difference in the incidence of other significant complications between the 2 types of sphincterotome.
Department of Endoscopy and Motility Unit, Medical School, Aristotle University of Thessaloniki, G. Gennimatas General Hospital, 54635 Thessaloniki, Greece. gchatzim@med.auth.gr