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Cited 9 time in webofscience Cited 9 time in scopus
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Can prophylactic argon plasma coagulation reduce delayed post-papillectomy bleeding? A prospective multicenter trial

Authors
Yang, Jae KookHyun, Jong JinLee, Tae HoonChoi, Jun-HoLee, Yun NahChoe, Jung WanPark, Jin-SeokKwon, Chang-IlJeong, SeokKim, Hong JaMoon, Jong HoPark, Sang-Heum
Issue Date
Feb-2021
Publisher
Blackwell Publishing Inc.
Keywords
Ampulla of Vater; Argon plasma coagulation; Bleeding; Papillectomy
Citation
Journal of Gastroenterology and Hepatology, v.36, no.2, pp.467 - 473
Indexed
SCIE
SCOPUS
Journal Title
Journal of Gastroenterology and Hepatology
Volume
36
Number
2
Start Page
467
End Page
473
URI
https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/33926
DOI
10.1111/jgh.15186
ISSN
0815-9319
Abstract
Background and Aim Endoscopic post-papillectomy bleeding occurs in 3% to 20% of the cases, and delayed bleeding is also problematic. However, there is no consensus on how to reduce delayed post-papillectomy bleeding. The aim of this study was to evaluate the efficacy of prophylactic argon plasma coagulation (APC) to minimize delayed bleeding and reduce the persistence of residual tumors after endoscopic papillectomy. Methods In a prospective pilot study of patients with benign ampullary tumors, the prophylactic APC group underwent APC at the resection margin following a conventional snaring papillectomy. Then, 24 h later after the papillectomy, all patients underwent a follow-up duodenoscopy to identify post-papillectomy bleeding and were followed up until 12 months. The main outcomes were the delayed (≥24 h) post-papillectomy bleeding rate and the tumor persistence rate. Results The delayed post-papillectomy bleeding rate was 30.8% (8/26) in the prophylactic APC group and 21.4% (6/28) in the non-APC group (P = 0.434). The post-procedure pancreatitis rates were 23.1% (6/26) and 35.7% (10/28), respectively (P = 0.310). The rate of tumor persistence did not differ between the two groups at 1 month (12.5% vs 7.4%, P = 0.656), 3 months (4.2% vs 3.7%, P = 1.00), 6 months (8.3% vs 3.7%, P = 0.595), and 12 months (0% vs 3.7%, P = 1.00). There were no procedure-related mortalities or serious complications. Conclusion Prophylactic APC may not be effective in reducing delayed post-papillectomy bleeding or remnant tumor ablation immediately after conventional papillectomy (Clinical trial registration—cris.nih.go.kr; KCT0001955).
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Choe, Jung Wan
Ansan Hospital (Department of Gastroenterology and Hepatology, Ansan Hospital)
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