Shionoya Kento, Koizumi Kazuya, Masuda Sakue, Kubota Jun, Kimura Karen, Makazu Makomo
Gastroenterology Medicine Center, Shonan Kamakura General Hospital, Kamakura-shi, Kanagawa, Japan.
Gastro Hep Adv. 2023 Jul 18;2(7):889-892. doi: 10.1016/j.gastha.2023.07.005. eCollection 2023.
A 58-year-old male with acute cholangitis due to a common bile duct stone underwent endoscopic retrograde cholangiopancreatography for stone removal with endoscopic papillary balloon dilation (EPBD) due to his high bleeding risk owing to maintenance dialysis and antiplatelet and anticoagulant medications. He had a history of stone removal using an EPBD. The stone was removed; however, the patient subsequently developed spurting bleeding and underwent endoscopic hemostasis. Despite the subsequent mild pancreatitis, he recovered with conservative management. While EPBD is considered a low-risk procedure for bleeding, caution should still be exercised due to the possibility of massive postprocedural bleeding.
一名58岁男性因胆总管结石引发急性胆管炎，由于维持性透析以及抗血小板和抗凝药物治疗导致出血风险高，遂接受了内镜逆行胰胆管造影术，通过内镜乳头球囊扩张术（EPBD）进行结石清除。他既往有使用EPBD清除结石的病史。结石已被清除；然而，患者随后出现喷射性出血，并接受了内镜止血治疗。尽管随后出现了轻度胰腺炎，但经保守治疗后康复。虽然EPBD被认为是一种出血风险较低的手术，但由于术后仍有可能发生大量出血，仍应谨慎操作。
