Effect of preventive closure of the frenulum after endoscopic papillectomy: A prospective pilot study.
Ampulla of Vater
/ surgery
Blood Loss, Surgical
/ prevention & control
Endoscopic Mucosal Resection
/ methods
Endoscopy
/ methods
Feasibility Studies
Female
Humans
Labial Frenum
/ surgery
Length of Stay
Male
Middle Aged
Pilot Projects
Prospective Studies
Safety
Surgical Instruments
Treatment Outcome
Wound Closure Techniques
ampullary tumor
endoscopic papillectomy
preventive closure
Journal
Journal of gastroenterology and hepatology
ISSN: 1440-1746
Titre abrégé: J Gastroenterol Hepatol
Pays: Australia
ID NLM: 8607909
Informations de publication
Date de publication:
Mar 2020
Mar 2020
Historique:
received:
16
04
2019
revised:
15
07
2019
accepted:
29
10
2019
pubmed:
7
11
2019
medline:
15
9
2020
entrez:
7
11
2019
Statut:
ppublish
Résumé
The usefulness of preventive closure of the frenulum after endoscopic papillectomy (EP) could reduce bleeding. The feasibility and safety of clipping were evaluated in this prospective pilot study. This study involved 40 consecutive patients who underwent preventive closure of the frenulum by clipping just after EP. The outcome data were compared with those of the previous 40 patients in whom no preemptive closure had been performed (no-closure group) (UMIN000014783). Additionally, the bleeding sites were examined. The clipping procedure was successful in all patients. As compared to the no-closure group, the rate of bleeding (P = 0.026) and period of hospital stay (P < 0.001) were significantly reduced in the closure group. There was no difference in the procedure time between the two groups. Furthermore, the incidence rates of pancreatitis and perforation were comparable in the two groups. The bleeding was noted in the frenulum area rather than at any other site in 90.9% of cases. Preventive closure of the frenulum after EP is an effective, safe, rational, and economical method to reduce the incidence of delayed bleeding, without prolonging the procedure time or increasing the risk of post-procedure pancreatitis perforation.
Sections du résumé
BACKGROUND AND AIM
OBJECTIVE
The usefulness of preventive closure of the frenulum after endoscopic papillectomy (EP) could reduce bleeding. The feasibility and safety of clipping were evaluated in this prospective pilot study.
METHODS
METHODS
This study involved 40 consecutive patients who underwent preventive closure of the frenulum by clipping just after EP. The outcome data were compared with those of the previous 40 patients in whom no preemptive closure had been performed (no-closure group) (UMIN000014783). Additionally, the bleeding sites were examined.
RESULTS
RESULTS
The clipping procedure was successful in all patients. As compared to the no-closure group, the rate of bleeding (P = 0.026) and period of hospital stay (P < 0.001) were significantly reduced in the closure group. There was no difference in the procedure time between the two groups. Furthermore, the incidence rates of pancreatitis and perforation were comparable in the two groups. The bleeding was noted in the frenulum area rather than at any other site in 90.9% of cases.
CONCLUSION
CONCLUSIONS
Preventive closure of the frenulum after EP is an effective, safe, rational, and economical method to reduce the incidence of delayed bleeding, without prolonging the procedure time or increasing the risk of post-procedure pancreatitis perforation.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
374-379Informations de copyright
© 2019 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.
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