Effective application of self-assembling peptide matrix with the gel immersion technique and red dichromatic imaging for hemostasis of postendoscopic sphincterotomy bleeding.

Abstract

Endoscopic sphincterotomy is an essential procedure during endoscopic retrograde cholangiopancreatography (ERCP) for the diagnosis or treatment of pancreaticobiliary disease; however, postendoscopic sphincterotomy bleeding occasionally occurs and is a potentially life-threatening adverse event [1]. Recently, a novel self-assembling peptide matrix (PuraStat; 3-D Matrix Europe SAS, France), which is approved for hemostasis in gastrointestinal endoscopic procedures, was launched [2]. Because of its characteristics, this product is not effective in achieving hemostasis of pooled blood, as the peptide matrix assembles when the solution comes into contact with body fluids. For effective hemostasis, the peptide matrix gel should be applied as close as possible to the bleeding point of the injured vessel wall. Herein, we report the effective application of PuraStat for hemostasis of postendoscopic sphincterotomy bleeding while securing an endoscopic field of view with the gel immersion technique [3] and red dichromatic imaging (RDI; Olympus, Japan) [4] [5] ([Video 1]).