Endoscopic treatment of refractory post-sphincterotomy bleeding with forceps electrocoagulation combined with prophylactic pancreatic stenting – a case series

Introduction: Bleeding is one of the most frequent complications of endoscopic sphincterotomy (ES) during endoscopic retrograde cholangio-pancreatography (ERCP) with an overall risk of 1 – 4%. Injection with diluted epinephrine is the standard first line endoscopic treatment option. In therapy resistant cases endoscopic hemoclipping has been demonstrated as an effective method; however, optimal positioning of hemoclips is difficult, moreover sometimes impossible. For refractory cases forceps electrocoagulation combined with prophylactic pancreatic stent (PPS) insertion might be an alternative new method. Patient…