Abstract
Hemostasis for post-endoscopic sphincterotomy (post-EST) bleeding involves no standard strategy. New clips designed for delivery using the duodenoscope (SureClip, Micro-Tech, Nanjing, China) have been utilized for gastrointestinal bleeding hemostasis and bleeding prevention after polypectomy and papillectomy. We retrospectively analyzed the effectiveness and safety of SureClip for post-EST bleeding. Of 608 patients with endoscopic sphincterotomy (EST), 41 cases (6.7%) experienced post-EST bleeding from 2019 to 2023. Of these patients, 24 underwent hemostasis by SureClip, and the success rate of complete hemostasis and complication by hemostasis by SureClip was analyzed. In 12 and 12 patients with urgent and delayed bleeding, 11 (91.7%) and 11 (91.7%) had successful hemostasis, respectively. Additionally, missed patients achieved complete hemostasis by additional transcatheter arterial embolization and balloon compression, respectively. No complications were observed, including perforation, pancreatitis, and clipping bile duct and pancreatic duct by mistake. Hemostasis by SureClip is safe and effective and not expensive for post-EST bleeding. It could be the first choice for hemostasis in patients with post-EST bleeding refractory for balloon compression.
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