P1707 - Novel Haemostatic Agents for Immediate Bleeding Management Using 5-Fr Cannula Catheter During Therapeutic Endoscopic Retrograde Cholangio-Pancreatography

Cosmas Rinaldi A. Lesmana, MD, PhD, FACG¹, Sharon Sandra, ¹, Laurentius Adrianto Lesmana, MD, PhD, FACG^2
1Dr. Cipto Mangunkusumo National General Hospital, Universitas Indonesia, Jakarta, Jakarta Raya, Indonesia; ²Digestive Disease & GI Oncology Center, Medistra Hospital, Jakarta, Jakarta Raya, Indonesia

Introduction:

Methods: This was an endoscopy database study of patients who underwent ERCP procedure in tertiary referral private hospitals within 2 years-period. Patients on anticoagulant or antiplatelet therapy, liver cirrhosis, chronic kidney disease or other coagulation disorders were excluded in this study. Statistical analyses were performed using Statistical Package for the Social Science (SPSS) for Windows, version 16.0.

Results: Of 392 patients who underwent ERCP with ES procedure, there were 302 patients who can be included for study analysis. Majority of patients are male between 20-98 years old. The most indication for ERCP procedures was choledocholithiasis. Immediate bleeding after sphincterotomy occurred in 121 patients, where 45 patients received standard haemostatic treatment and 76 patients received novel haemostatic agents. Initial haemostatic was achieved in all patients. However, 2 patients who received standard haemostatic treatment had rebleeding and the bleeding was stopped with novel haemostatic agent in one patient and argon plasma coagulation (APC) in another patient. No patients in novel haemostatic treatment had rebleeding. Additional study analysis revealed that pancreatitis complication occurred more frequently in novel haemostatic treatment when compared to standard haemostatic treatment, but it was not statistically significant (81.2 % VS 18.8%, p =0. 101).

Discussion: To our knowledge, this is the first study with a large number of patients, looking at the role of novel haemostatic agents as the first choice for immediate bleeding management during ERCP procedures in all patients who underwent ES. We have shown the innovative method by using two 5-fr cannula catheters when the double lumen catheter is not available since the process needs the two-vial compound injected together. Even though the standard conventional haemostatic management is still quite effective in post ES bleeding, however, the innovation method has made easier to perform for experience as well as less experience endoscopists.



Disclosures:


Cosmas Rinaldi A. Lesmana, MD, PhD, FACG¹, Sharon Sandra, ¹, Laurentius Adrianto Lesmana, MD, PhD, FACG². P1707 - Novel Haemostatic Agents for Immediate Bleeding Management Using 5-Fr Cannula Catheter During Therapeutic Endoscopic Retrograde Cholangio-Pancreatography, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.