Hemorrhage from the Major Duodenal Papilla after Endoscopic Retrograde Cholecystopancreatography
Hemorrhage from the major duodenal papilla (MDP) is a most common complication of endoscopic retrograde cholecystopancreatography (ERCPG) with/without papillosphincterotomy (PST).The objective of the present study was to estimate the frequency of this complication and to evaluate the efficiency of m...
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Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, Moscow, Russia
2007-02-01
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| Series: | Общая реаниматология |
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| Online Access: | https://www.reanimatology.com/rmt/article/view/1079 |
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| author | M. P. Mantserov Ye. V. Moroz V. L. Astashov |
| author_facet | M. P. Mantserov Ye. V. Moroz V. L. Astashov |
| author_sort | M. P. Mantserov |
| collection | DOAJ |
| description | Hemorrhage from the major duodenal papilla (MDP) is a most common complication of endoscopic retrograde cholecystopancreatography (ERCPG) with/without papillosphincterotomy (PST).The objective of the present study was to estimate the frequency of this complication and to evaluate the efficiency of methods for its prevention.Subjects and methods: In 1994 to 2005, the N. N. Burdenko Main Military Hospital performed 1373 ERCPGs with/without PST. The patients were divided into 2 groups: 1) 326 patients (males, 75.1%; mean age, 58.2±16.1 years) who had no drug preventive therapy for postmanipulation complications and PST was performed by the routine procedure; 2) 1047 patients (males, 71.9%; mean age, 56.3±14.5 years) who had endoscopic (PST being performed, by using atypical or combined procedures) and drug (octreotide and protease inhibitors) prevention of complications. The incidence of hemorrhage from MDP and a need for endoscopic bleeding arrest were estimated.Results: Just after the manipulation, hemorrhage requiring endoscopic arrest occurred in 24 (7.3%) and 43 (4.1%) patients in Groups 1 and 2, respectively (p<0.001). Following 24 hours, hemorrhage developed in 6 (13.9%) and 3 (3.9%) patients (p<0.001), this requiring surgical intervention in 1 (2.3%) and 2 (26%) patients from Groups 1 and 2, respectively. After 48 hours, hemorrhage recurred in 1 patient in each of the study groups and the signs of unstable hemostasis in esogaso-duodenoscopy (Forrest 2 a,b) were detected in 6 (139%) and 5 (6.6%) patients in Groups 1 and 2, respectively (p<0.05).Conclusion: After ERCPG with PST, hemorrhage occurs in 4.9% of the patients. PST by atypical and combined procedures and the administration of octreotide and protease inhibitors effectively reduce the risk of this complication. |
| format | Article |
| id | doaj-art-3aa61a7c866e42079a263b552d7e543f |
| institution | Kabale University |
| issn | 1813-9779 2411-7110 |
| language | English |
| publishDate | 2007-02-01 |
| publisher | Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, Moscow, Russia |
| record_format | Article |
| series | Общая реаниматология |
| spelling | doaj-art-3aa61a7c866e42079a263b552d7e543f2025-08-20T03:43:41ZengFederal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, Moscow, RussiaОбщая реаниматология1813-97792411-71102007-02-0131121510.15360/1813-9779-2007-1-12-151079Hemorrhage from the Major Duodenal Papilla after Endoscopic Retrograde CholecystopancreatographyM. P. Mantserov0Ye. V. Moroz1V. L. Astashov2N. N. Burdenko Main Military Hospital, MoscowN. N. Burdenko Main Military Hospital, MoscowN. N. Burdenko Main Military Hospital, MoscowHemorrhage from the major duodenal papilla (MDP) is a most common complication of endoscopic retrograde cholecystopancreatography (ERCPG) with/without papillosphincterotomy (PST).The objective of the present study was to estimate the frequency of this complication and to evaluate the efficiency of methods for its prevention.Subjects and methods: In 1994 to 2005, the N. N. Burdenko Main Military Hospital performed 1373 ERCPGs with/without PST. The patients were divided into 2 groups: 1) 326 patients (males, 75.1%; mean age, 58.2±16.1 years) who had no drug preventive therapy for postmanipulation complications and PST was performed by the routine procedure; 2) 1047 patients (males, 71.9%; mean age, 56.3±14.5 years) who had endoscopic (PST being performed, by using atypical or combined procedures) and drug (octreotide and protease inhibitors) prevention of complications. The incidence of hemorrhage from MDP and a need for endoscopic bleeding arrest were estimated.Results: Just after the manipulation, hemorrhage requiring endoscopic arrest occurred in 24 (7.3%) and 43 (4.1%) patients in Groups 1 and 2, respectively (p<0.001). Following 24 hours, hemorrhage developed in 6 (13.9%) and 3 (3.9%) patients (p<0.001), this requiring surgical intervention in 1 (2.3%) and 2 (26%) patients from Groups 1 and 2, respectively. After 48 hours, hemorrhage recurred in 1 patient in each of the study groups and the signs of unstable hemostasis in esogaso-duodenoscopy (Forrest 2 a,b) were detected in 6 (139%) and 5 (6.6%) patients in Groups 1 and 2, respectively (p<0.05).Conclusion: After ERCPG with PST, hemorrhage occurs in 4.9% of the patients. PST by atypical and combined procedures and the administration of octreotide and protease inhibitors effectively reduce the risk of this complication.https://www.reanimatology.com/rmt/article/view/1079endoscopic retrograde cholecystopancreatographycomplicationsgastrointestinal bleedingtreatmentprevention |
| spellingShingle | M. P. Mantserov Ye. V. Moroz V. L. Astashov Hemorrhage from the Major Duodenal Papilla after Endoscopic Retrograde Cholecystopancreatography Общая реаниматология endoscopic retrograde cholecystopancreatography complications gastrointestinal bleeding treatment prevention |
| title | Hemorrhage from the Major Duodenal Papilla after Endoscopic Retrograde Cholecystopancreatography |
| title_full | Hemorrhage from the Major Duodenal Papilla after Endoscopic Retrograde Cholecystopancreatography |
| title_fullStr | Hemorrhage from the Major Duodenal Papilla after Endoscopic Retrograde Cholecystopancreatography |
| title_full_unstemmed | Hemorrhage from the Major Duodenal Papilla after Endoscopic Retrograde Cholecystopancreatography |
| title_short | Hemorrhage from the Major Duodenal Papilla after Endoscopic Retrograde Cholecystopancreatography |
| title_sort | hemorrhage from the major duodenal papilla after endoscopic retrograde cholecystopancreatography |
| topic | endoscopic retrograde cholecystopancreatography complications gastrointestinal bleeding treatment prevention |
| url | https://www.reanimatology.com/rmt/article/view/1079 |
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