Evidence-based Case Discussion for Post-ERCP Hemobilia_Chinese Journal of Evidence-Based Medicine

Authors：

ZHANG Ying ¹ , CHEN Shiyao ²

1. Department of Gastroenterology, Hua Dong Hospital, Shanghai 200040, China2. Department of Gastroenterology, Zhong Shah Hospital, Fu Dan University, Shanghai 200032, China;

Corresponding author：

Keywords：

Endoscopic retrograde Cholangiopancreatography; Hemobilia; Evidenced-based medicine

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Objective 　To analyze and explain how to treat 1 patient with post-ERCP hemobilia based on best clinical evidence.
Methods 　We used EST and EPBD, ENBD, Hemobilia as key words to search MEDLINE （1978 ～ 2004） and CBMdisc（1978 ～ 2004） to find the best clinical evidence and evaluated the quality of evidence.
Results 　According to the evidence, we found that endoscopic papillary balloon dilation （EPBD） or endoscopic nasobiliary drainage （ ENBD ） may be more effective and better tolerated in the treatment ofpost-ERCP hemobilia. Our patient did not receive sufficient medical treatment after hemobilia. He was not given a general assessment before surgery including liver function tests. As a result, the patient died of liver failure and its complications.
Conclusions 　We should treat such patients promptly and efficiendy after hemobilia. We should also evaluate their general condition properly before the operation.

Citation： ZHANG Ying,CHEN Shiyao. Evidence-based Case Discussion for Post-ERCP Hemobilia. Chinese Journal of Evidence-Based Medicine, 2005, 05(10): 797-803. doi: Copy

1.	刘国礼.腹腔镜胆囊切除现状与展望[J].肝胆胰外科杂志,2000;12(1):1～2.
2.	Takezawa M,Kida Y,Kida M,Saigenji K.Influence of endoscopic papillary balloon dilation and endoscopic sphincterotomy on sphincter of oddi function:a randomized controlled trial[J].Endoscopy,2004;36(7):631-637.
3.	Yao LQ,Zhang YQ,Zhou PH,Gao WD,He GJ,Xu MD.Endoscopic sphincterotomy or papillary balloon dilatation for choledocholithiasis[J].Hepatobiliary Pancreat Dis Int,2002;1(1):101-105.
4.	Natsui M,Narisawa R,Motoyama H,Hayashi S,Seki K,Wakabayashi H,Itoh S,Asakura H.What is an appropriate indication for endoscopic papillary balloon dilation[J]? Eur J Gastroenterol Hepatol,2002;14(6):635-640.
5.	Yasuda I,Tomita E,Enya M,Kato T,Moriwaki H.Can endoscopic papillary balloon dilation really preserve sphincter of Oddi function[J]? Gut,2001;49(5):686-691.
6.	Sharma VK,Howden CW.Metaanalysis of randomized controlled trials of endoscopic retrograde cholangiography and endoscopic sphincterotomy for the treatment of acute biliary pancreatitis[J].Am J Gastroenterol,1999;94(11):3211-3214.
7.	Baron TH,Harewood GC.Endoscopic balloon dilation of the biliary sphincter compared to endoscopic biliary sphincterotomy for removal of common bile duct stones during ERCP:a metaanalysis of randomized,controlled trials[J].Am J Gastroenterol,2004;99(8):1455-1460.
8.	Kawai K,Akasaka Y,Murakami K,Tada M,Koli Y.Endoscopic sphincterotomy of the ampulla of vater[J].Gastrointest Endosc,1974;20(4):148-151.
9.	Staritz M,Ewe K,Meyer zum Buschenfelde KH.Endoscopic papillary dilation (EPD) for treatment of common bile duct stones and papillary stenosis[J].Endoscopy,1983;15(S1):197-198.
10.	May GR,Cotton PB,Edmunds SE,Chong W.Removal of stones from the bile duct at ERCP without sphincterotomy[J].Gastrointest Endosc,1993;39(6):749-754.
11.	Mac Mathuna P,White P,Clarke E,Lennon J,Crowe J.Endoscopic sphincteroplasty:a novel and safe alternative to papillotomy in the management of bile duct stones[J].Gut,1994;35(1):127-129.
12.	Bergman J,Rauws E,Fockens P,van Berkel AM,Bossuyt PM,Tijssen J,Tytgat G,Huibregtse K.Randomised trial of endoscopic balloon dilation versus endoscopic sphincterotomy for removal of bileduct stones[J].Lancet,1997;349(9059):1124-1129.
13.	Kawabe T,Komatsu Y,Isayama H,Takemura T,Toda N,Tada M,Imai Y.Histological analysis of the papilla after endoscopic papillary balloon dilation[J].Hepatogastroenterology,2003;50(52):919-923.
14.	Vlavianos P,Chopra K,Mandalia S,Anderson M,Thompson J,Westaby D.Endoscopic balloon dilatation versus endoscopic sphincterotomy for the removal of bile duct stones:a prospective randomised trial[J].Gut,2003;52(8):1165-1169.
15.	Freeman ML,Nelson DB,Sherman S,Haber GB,Herman ME,Dorsher PJ,Moore JP.Complications of endoscopic biliary sphincterotomy[J].N Engl J Med,1996;335(13):909-918.
16.	Coppola R,Riccioni ME,Ciletti S,Cosentino L,Coco C,Magistrelli P,Picciocchi A.Analysis of complications of endoscopic sphincterotomy for biliary stones in a consecutive series of 546 patients[J].Surg Endosc,1997;11(2):129-132.
17.	Kawabe T,Komatsu Y,Tada M,Toda N,Ohashi M,Shiratori Y,Omata M.Endoscopic papillary balloon dilation in cirrhotic patients:removal of common bile duct stones without sphincterotomy[J].Endoscopy,1996;28(8):694-698.
18.	Prat F,Tennenbaum R,Ponsot P,Altman C,Pelletier G,Fritsch J,Choury AD,Bernades P,Etienne JP.Endoscopic sphincterotomy patients with liver cirrhosis[J].Gastrointest Endosc,1996;43(2 pt 1):127-131.
19.	Chawla YK,Sharma BC,Dilawari JB.Endoscopic nasobiliary drainage in acute suppurative cholangitis[J].Indian J Gastroenterol,1994;13(3):83-85.
20.	Sharma BC,Agarwal DK,Baijal SS,Saraswat VA,Choudhuri G,Naik SR.Endoscopic management of acute calculous cholangitis[J].J Gastroenterol Hepatol,1997;12(12):874-876.
21.	Sugiyama M,Atomi Y.The benefits of endoscopic nasobiliary drainage without sphincterotomy for acute cholangitis[J].Am J Gastroenterol,1998;93(11):2065-2068.
22.	Sugiyama M;Mori T;Atomi Y.Endoscopic nasobiliary drainage for treating bile leak after laparoscopic cholecystectomy[J].Hepatogastroenterology,1999;46(26):762-765.
23.	Sandblom P.Hemorrhage into the biliary tract following trauma:"traumatic hemobilia"[J].Surgery,1948;24(5):571-586.
24.	Green MH,Duell RM,Johnson CD,Jamieson NV.Haemobilia[J].Br J Surg,2001;88(6):773-786.
25.	Gholson F,Favrot D,Vickers B,Dies D,Wilder W.Delayed hemorrhage following endoscopic retrograde sphincterotomy for choledocholithiasis[J].Dig Dis Sci,1996;41(5):831-834.
26.	Sears RJ,Ishitani MB,Bickston SJ.Endoscopic diagnosis and therapy of a case of bilhemia after percutaneous liver biopsy[J].Gastrointest Endosc,1997;46(3):276-279.
27.	Tobin MV,Jenkins SA,Gosney JR,Gilmore IT.Use of somatostatin in the management of pancreatic haemobilia[J].Postgrad Med J,1989;65(763):331-332.
28.	Rosen RJ,Sanchez G.Angiographic diagnosis and management of gastrointestinal hemorrhage.Current concepts[J].Radiol Clin North Am,1994;32(5):951-967.
29.	Nicholson T,Travis S,Ettles D,Dyet J,Sedman P,Wedgewood K,Royston C.Hepatic artery angiography and embolization for hemobilia following laparoscopic cholecystectomy[J].Cardiovasc Intervent Radiol,1999;22(1):20-24.
30.	D’Albuquerque LA,de Miranda MP,Genzini T,Copstein JL,de Oliveira e Silva A.Laparoscopic cholecystectomy in cirrhotic patients[J].Surg Laparosc Endosc,1995;5(4):272-276.
31.	Liu GL.The status quo and prospect of laparoscopic cholecystectomy[J].Journal of Hepatopancreatobiliary Surgery,2000;12(1):1-2.
32.	Aranha GV,Sontag SJ,Greenlee HB.Cholecystectomy in cirrhotic patients:a formidable operation[J].Am J Surg,1982;143(1):55-60.
33.	Yerdel MA,Tsuge H,Mimura H,Sakagami K,Mori M,Orita K.Laparoscopic cholecystectomy in cirrhotic patients:expanding indications[J].Surg Laparosc Endosc,1993;3(3):180-183.

1. 刘国礼.腹腔镜胆囊切除现状与展望[J].肝胆胰外科杂志,2000;12(1):1～2.
2. Takezawa M,Kida Y,Kida M,Saigenji K.Influence of endoscopic papillary balloon dilation and endoscopic sphincterotomy on sphincter of oddi function:a randomized controlled trial[J].Endoscopy,2004;36(7):631-637.
3. Yao LQ,Zhang YQ,Zhou PH,Gao WD,He GJ,Xu MD.Endoscopic sphincterotomy or papillary balloon dilatation for choledocholithiasis[J].Hepatobiliary Pancreat Dis Int,2002;1(1):101-105.
4. Natsui M,Narisawa R,Motoyama H,Hayashi S,Seki K,Wakabayashi H,Itoh S,Asakura H.What is an appropriate indication for endoscopic papillary balloon dilation[J]? Eur J Gastroenterol Hepatol,2002;14(6):635-640.
5. Yasuda I,Tomita E,Enya M,Kato T,Moriwaki H.Can endoscopic papillary balloon dilation really preserve sphincter of Oddi function[J]? Gut,2001;49(5):686-691.
6. Sharma VK,Howden CW.Metaanalysis of randomized controlled trials of endoscopic retrograde cholangiography and endoscopic sphincterotomy for the treatment of acute biliary pancreatitis[J].Am J Gastroenterol,1999;94(11):3211-3214.
7. Baron TH,Harewood GC.Endoscopic balloon dilation of the biliary sphincter compared to endoscopic biliary sphincterotomy for removal of common bile duct stones during ERCP:a metaanalysis of randomized,controlled trials[J].Am J Gastroenterol,2004;99(8):1455-1460.
8. Kawai K,Akasaka Y,Murakami K,Tada M,Koli Y.Endoscopic sphincterotomy of the ampulla of vater[J].Gastrointest Endosc,1974;20(4):148-151.
9. Staritz M,Ewe K,Meyer zum Buschenfelde KH.Endoscopic papillary dilation (EPD) for treatment of common bile duct stones and papillary stenosis[J].Endoscopy,1983;15(S1):197-198.
10. May GR,Cotton PB,Edmunds SE,Chong W.Removal of stones from the bile duct at ERCP without sphincterotomy[J].Gastrointest Endosc,1993;39(6):749-754.
11. Mac Mathuna P,White P,Clarke E,Lennon J,Crowe J.Endoscopic sphincteroplasty:a novel and safe alternative to papillotomy in the management of bile duct stones[J].Gut,1994;35(1):127-129.
12. Bergman J,Rauws E,Fockens P,van Berkel AM,Bossuyt PM,Tijssen J,Tytgat G,Huibregtse K.Randomised trial of endoscopic balloon dilation versus endoscopic sphincterotomy for removal of bileduct stones[J].Lancet,1997;349(9059):1124-1129.
13. Kawabe T,Komatsu Y,Isayama H,Takemura T,Toda N,Tada M,Imai Y.Histological analysis of the papilla after endoscopic papillary balloon dilation[J].Hepatogastroenterology,2003;50(52):919-923.
14. Vlavianos P,Chopra K,Mandalia S,Anderson M,Thompson J,Westaby D.Endoscopic balloon dilatation versus endoscopic sphincterotomy for the removal of bile duct stones:a prospective randomised trial[J].Gut,2003;52(8):1165-1169.
15. Freeman ML,Nelson DB,Sherman S,Haber GB,Herman ME,Dorsher PJ,Moore JP.Complications of endoscopic biliary sphincterotomy[J].N Engl J Med,1996;335(13):909-918.
16. Coppola R,Riccioni ME,Ciletti S,Cosentino L,Coco C,Magistrelli P,Picciocchi A.Analysis of complications of endoscopic sphincterotomy for biliary stones in a consecutive series of 546 patients[J].Surg Endosc,1997;11(2):129-132.
17. Kawabe T,Komatsu Y,Tada M,Toda N,Ohashi M,Shiratori Y,Omata M.Endoscopic papillary balloon dilation in cirrhotic patients:removal of common bile duct stones without sphincterotomy[J].Endoscopy,1996;28(8):694-698.
18. Prat F,Tennenbaum R,Ponsot P,Altman C,Pelletier G,Fritsch J,Choury AD,Bernades P,Etienne JP.Endoscopic sphincterotomy patients with liver cirrhosis[J].Gastrointest Endosc,1996;43(2 pt 1):127-131.
19. Chawla YK,Sharma BC,Dilawari JB.Endoscopic nasobiliary drainage in acute suppurative cholangitis[J].Indian J Gastroenterol,1994;13(3):83-85.
20. Sharma BC,Agarwal DK,Baijal SS,Saraswat VA,Choudhuri G,Naik SR.Endoscopic management of acute calculous cholangitis[J].J Gastroenterol Hepatol,1997;12(12):874-876.
21. Sugiyama M,Atomi Y.The benefits of endoscopic nasobiliary drainage without sphincterotomy for acute cholangitis[J].Am J Gastroenterol,1998;93(11):2065-2068.
22. Sugiyama M;Mori T;Atomi Y.Endoscopic nasobiliary drainage for treating bile leak after laparoscopic cholecystectomy[J].Hepatogastroenterology,1999;46(26):762-765.
23. Sandblom P.Hemorrhage into the biliary tract following trauma:"traumatic hemobilia"[J].Surgery,1948;24(5):571-586.
24. Green MH,Duell RM,Johnson CD,Jamieson NV.Haemobilia[J].Br J Surg,2001;88(6):773-786.
25. Gholson F,Favrot D,Vickers B,Dies D,Wilder W.Delayed hemorrhage following endoscopic retrograde sphincterotomy for choledocholithiasis[J].Dig Dis Sci,1996;41(5):831-834.
26. Sears RJ,Ishitani MB,Bickston SJ.Endoscopic diagnosis and therapy of a case of bilhemia after percutaneous liver biopsy[J].Gastrointest Endosc,1997;46(3):276-279.
27. Tobin MV,Jenkins SA,Gosney JR,Gilmore IT.Use of somatostatin in the management of pancreatic haemobilia[J].Postgrad Med J,1989;65(763):331-332.
28. Rosen RJ,Sanchez G.Angiographic diagnosis and management of gastrointestinal hemorrhage.Current concepts[J].Radiol Clin North Am,1994;32(5):951-967.
29. Nicholson T,Travis S,Ettles D,Dyet J,Sedman P,Wedgewood K,Royston C.Hepatic artery angiography and embolization for hemobilia following laparoscopic cholecystectomy[J].Cardiovasc Intervent Radiol,1999;22(1):20-24.
30. D’Albuquerque LA,de Miranda MP,Genzini T,Copstein JL,de Oliveira e Silva A.Laparoscopic cholecystectomy in cirrhotic patients[J].Surg Laparosc Endosc,1995;5(4):272-276.
31. Liu GL.The status quo and prospect of laparoscopic cholecystectomy[J].Journal of Hepatopancreatobiliary Surgery,2000;12(1):1-2.
32. Aranha GV,Sontag SJ,Greenlee HB.Cholecystectomy in cirrhotic patients:a formidable operation[J].Am J Surg,1982;143(1):55-60.
33. Yerdel MA,Tsuge H,Mimura H,Sakagami K,Mori M,Orita K.Laparoscopic cholecystectomy in cirrhotic patients:expanding indications[J].Surg Laparosc Endosc,1993;3(3):180-183.

Chinese Journal of Evidence-Based Medicine

Evidence-based Case Discussion for Post-ERCP Hemobilia

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