Endoscopic sphincterotomy–induced hemorrhage: treatment with heat probe.

Background: Endoscopic sphincterotomy (ES)–induced hemorrhage is a serious complication of ERCP and occurs in 1% to 2% of all procedures. A heat probe has been used effectively for many causes of GI hemorrhages. We prospectively investigated the efficacy and the safety of heat probe usage in patients with ES-induced hemorrhage. Methods: Between July 2002 and March 2004, ERCP procedures with ES were evaluated prospectively for complications. A heat probe was used to control ES-induced hemorrhages. Results: ES was performed in 703 of a total of 1262 (55.7%) ERCP procedures. ES-induced hemorrhage occurred in 16 patients (2.3%; 10 men, 6 women; 59.6 ± 15.2 years). Six of 16 patients bled during ERCP, and all bleeding was controlled by heat probe. Ten patients hemorrhaged after ERCP: 6 patients needed endoscopic treatment with heat probe, and 4 were followed up with supportive treatment without the need for any further treatment. There was no complication caused by the heat probe in this series. Conclusions: Heat probe is an easy, safe, and effective procedure for ES-induced hemorrhage treatment. [Copyright &y& Elsevier]