Subscribe to RSS
![](/products/assets/desktop/img/oa-logo.png)
DOI: 10.4103/jde.JDE_41_17
Soft Coagulation Using Hemostatic Forceps for Prevention of Postendoscopic Papillectomy Hemorrhage
Publication History
Publication Date:
24 September 2019 (online)
![](https://www.thieme-connect.de/media/10.1055-s-00043283/201803/lookinside/thumbnails/10-4103-jde-jde_41_17_0114-1.jpg)
Aim: Few reports of the prophylactic use of soft coagulation with hemostatic forceps for postendoscopic papillectomy hemorrhage (PEPH) have been presented. The aim of this study was to clarify the utility of that procedure for prophylaxis. Materials and Methods: From April 2009 to March 2012, PEPH was treated in four patients after the development of the condition with a conventional procedure at our institution. Thereafter, from April 2012 to March 2016, soft coagulation using hemostatic forceps was performed as prophylactic hemostasis following an EP in five patients. For the latter procedure, the hemostatic forceps device (FD411‑QR, Olympus, Tokyo, Japan) was used in a closed position, with the coagulation wave set at 60 W (VIO 300D; ERBE, Tubingen, Germany). The primary outcome was the onset of PEPH, which was defined as a decrease in hemoglobin ≥2 g/dL after EP. Secondary endpoints were the success rate and the incidence of adverse events of soft coagulation using hemostatic forceps for emergency bleeding cases after EP. Results: The incidence of PEPH was 20% (1 of 5 cases) in the prophylactic procedure group, which was lower than that in the conventional procedures group (75%, 3 of 4 cases), though the difference was not statistically significant (P = 0.206, Fisher’s exact test). All cases of PEPH were successfully treated by soft coagulation using hemostatic forceps. Conclusion: Soft coagulation with hemostatic forceps may be suitable for use as a routine technique following EP to prevent PEPH.
-
References
- 1 Napoleon B, Gincul R, Ponchon T, Berthiller J, Escourrou J, Canard JM. et al Endoscopic papillectomy for early ampullary tumors: Long-term results from a large multicenter prospective study. Endoscopy 2014; 46: 127-34
- 2 Irani S, Arai A, Ayub K, Biehl T, Brandabur JJ, Dorer R. et al Papillectomy for ampullary neoplasm: Results of a single referral center over a 10-year period. Gastrointest Endosc 2009; 70: 923-32
- 3 Ito K, Fujita N, Noda Y, Kobayashi G, Obana T, Horaguchi J. et al Impact of technical modification of endoscopic papillectomy for ampullary neoplasm on the occurrence of complications. Dig Endosc 2012; 24: 30-5
- 4 Klein A, Tutticci N, Bourke MJ. Endoscopic resection of advanced and laterally spreading duodenal papillary tumors. Dig Endosc 2016; 28: 121-30
- 5 Binmoeller KF, Boaventura S, Ramsperger K, Soehendra N. Endoscopic snare excision of benign adenomas of the papilla of vater. Gastrointest Endosc 1993; 39: 127-31
- 6 De Palma GD. Endoscopic papillectomy: Indications, techniques, and results. World J Gastroenterol 2014; 20: 1537-43
- 7 Tsuji S, Itoi T, Sofuni A, Mukai S, Tonozuka R, Moriyasu F. et al Tips and tricks in endoscopic papillectomy of ampullary tumors: Single-center experience with large case series (with videos). J Hepatobiliary Pancreat Sci 2015; 22: E22-7
- 8 Mutignani M, Seerden T, Tringali A, Feisal D, Perri V, Familiari P. et al Endoscopic hemostasis with fibrin glue for refractory postsphincterotomy and postpapillectomy bleeding. Gastrointest Endosc 2010; 71: 856-60
- 9 Fujishiro M, Abe N, Endo M, Kawahara Y, Shimoda R, Nagata S. et al Retrospective multicenter study concerning electrocautery forceps with soft coagulation for nonmalignant gastroduodenal ulcer bleeding in japan. Dig Endosc 2010; 22 Suppl 1 S15-8
- 10 Nunoue T, Takenaka R, Hori K, Okazaki N, Hamada K, Baba Y. et al A randomized trial of monopolar soft-mode coagulation versus heater probe thermocoagulation for peptic ulcer bleeding. J Clin Gastroenterol 2015; 49: 472-6
- 11 Arima S, Sakata Y, Ogata S, Tominaga N, Tsuruoka N, Mannen K. et al Evaluation of hemostasis with soft coagulation using endoscopic hemostatic forceps in comparison with metallic hemoclips for bleeding gastric ulcers: A prospective, randomized trial. J Gastroenterol 2010; 45: 501-5