Endoscopic sphincterotomy–induced hemorrhage: treatment with heat probe

BackgroundEndoscopic 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.MethodsBetween July 2002 and March 2004, ERCP procedures with ES were evaluated prospectively for complications. A heat probe was used to control ES-induced hemorrhages.ResultsES 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.ConclusionsHeat probe is an easy, safe, and effective procedure for ES-induced hemorrhage treatment.