Ferreira Lincoln E V V C, Baron Todd H
Department of Medicine, Division of Gastroenterology & Hepatology, Mayo Clinic College of Medicine, Rochester, Minnesota 55905, USA.
Am J Gastroenterol. 2007 Dec;102(12):2850-8. doi: 10.1111/j.1572-0241.2007.01563.x.
Endoscopic biliary sphincterotomy (ES) is the cornerstone of therapeutic endoscopic retrograde cholangiopancreatography (ERCP). Bleeding is one of the most frequent complications following ES. Rates of post-ES bleeding vary widely and its presentation may be immediate (intraprocedural) or several days later. Clinically, bleeding can range from insignificant to life threatening. Most bleeding episodes are managed successfully by conservative measures with or without endoscopic therapy. Endoscopic treatment options include injection, thermal, and mechanical methods-alone or in combination. For refractory cases, angiographic embolization, or surgery, is necessary. Both technical risk factors and patient risk factors contribute to the development of post-ES bleeding. When these risk factors are present, measures can be taken to reduce the risk of bleeding. In this manuscript the literature on post-ES bleeding is reviewed.
内镜下胆管括约肌切开术（ES）是治疗性内镜逆行胰胆管造影术（ERCP）的基石。出血是ES术后最常见的并发症之一。ES术后出血的发生率差异很大，其表现可能是即刻的（术中）或数天后出现。临床上，出血程度可轻可重，甚至危及生命。大多数出血事件通过保守治疗（无论是否联合内镜治疗）均可成功处理。内镜治疗方法包括注射、热凝和机械方法，可单独使用或联合使用。对于难治性病例，需要进行血管造影栓塞或手术治疗。技术风险因素和患者风险因素均会导致ES术后出血。当存在这些风险因素时，可采取措施降低出血风险。本文对ES术后出血的相关文献进行综述。
