Practical Experiences of Unsuccessful Hemostasis with Covered Self-Expandable Metal Stent Placement for Post-Endoscopic Sphincterotomy Bleeding.
Practical Experiences of Unsuccessful Hemostasis with Covered Self-Expandable Metal Stent Placement for Post-Endoscopic Sphincterotomy Bleeding.
复制标题
止血性不成功的实用经验，具有覆盖的自膨胀金属支架放置，以用于后镜检查后括约肌切开术出血。
DOI：
10.5946/ce.2020.217
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发表时间：
2022-01
影响因子：
2.5
通讯作者：
Kataoka H
中科院分区：
文献类型：
--
作者：
Yoshida M;Inoue T;Naitoh I;Hayashi K;Hori Y;Natsume M;Atsuta N;Kataoka H
我们回顾了7例内镜下使用有盖自膨胀金属支架（cems）治疗内镜下括约肌切开术（ES）出血不成功的患者。6例采用中等切口，1例采用大切口。除1例（86%）外，所有患者均出现延迟出血，需要第二次内镜治疗，然后在初次ES后1 - 5天放置cems。随后的cems安置没有在任何患者中实现完全止血。侧切口（3、9点钟）出血点发生率（71%）高于口侧切口（11 ~ 12点钟）；使用止血钳、高渗生理盐水肾上腺素或血夹进行额外的内镜止血手术获得了良好的止血效果，导致所有患者完全止血。这些经验提供了一个警告：cems安置不是es后出血的最终治疗方法，尽管它有效。即使在放置cems后，也应仔细检查切口线的外侧以及口腔最侧是否有出血点。
We reviewed 7 patients with unsuccessful endoscopic hemostasis using covered self-expandable metal stent (CSEMS) placement for post-endoscopic sphincterotomy (ES) bleeding. ES with a medium incision was performed in 6 and with a large incision in 1 patient. All but 1 of them (86%) showed delayed bleeding, warranting second endoscopic therapies followed by CSEMS placement 1–5 days after the initial ES. Subsequent CSEMS placement did not achieve complete hemostasis in any of the patients. Lateral-side incision lines (3 or 9 o’clock) had more frequent bleeding points (71%) than oral-side incision lines (11–12 o’clock; 29%). Additional endoscopic hemostatic procedures with hemostatic forceps, hypertonic saline epinephrine, or hemoclip achieved excellent hemostasis, resulting in complete hemostasis in all patients. These experiences provide an alert: CSEMS placement is not an ultimate treatment for post-ES bleeding, despite its effectiveness. The lateral-side of the incision line, as well as the oral-most side, should be carefully examined for bleeding points, even after the CSEMS placement.
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DOI：
10.1007/s00464-012-2368-3
发表时间：
2013-01-01
影响因子：
3.1
作者：
Canena, Jorge;Liberato, Manuel;Coutinho, Antonio
通讯作者：
Coutinho, Antonio
影响因子：
7.7
作者：
Loperfido, S;Angelini, G;Fratton, A
通讯作者：
Fratton, A
影响因子：
158.5
作者：
Freeman, ML;Nelson, DB;Pheley, AM
通讯作者：
Pheley, AM
影响因子：
3.1
作者：
Inoue, Tadahisa;Ibusuki, Mayu;Yoneda, Masashi
通讯作者：
Yoneda, Masashi
影响因子：
9.3
作者：
Itoi, T.;Yasuda, I.;Sofuni, A.
通讯作者：
Sofuni, A.