Management of postendoscopic sphincterotomy bleeding with fully covered self‐expanding metal stent

Abstract

Postendoscopic sphincterotomy (ES) bleeding is one of the most frequent complications following ES. Different endoscopic interventions are available to manage post‐ES bleeding. Recently, the temporary placement of fully covered self‐expanding metal stent (FCSEMS) to achieve a tamponade effect has been described in post‐ES bleeding not controlled by other measures. The aim of this article is to present our clinical experience with management of post‐ES bleeding using FCSEMS. This is a retrospective analysis of prospectively collected data involving six patients who received FCSEMS for post‐ES bleeding after failure of traditional endoscopic interventions between the period of January 2013 and December 2016. Success of hemostasis and development of complications were evaluated. Successful hemostasis was achieved in all patients although one patient required additional endoscopic intervention after stent deployment. Two cases of pancreatitis were observed. There was no stent migration encountered. Temporary placement of FCSEMS is a safe and effective method to achieve hemostasis in post‐ES bleeding when primary endoscopic interventions failed. However, we should be aware of possible pancreatitis complications.