An Analysis Of The Feasibility And Effectiveness Of Using "Hexie" Titanium Clips To Cure Hemorrhage After ERCP

Objective: To investigate an analysis of the feasibility and effectiveness of using “Hexie” titanium clips to cure hemorrhage after ERCPMethod: 21 patients with cholelithiasis,who were performed with ERCP for stone extraction in our hospital from 2016/03 to 2017/04,were analyzed retrospectively.20 cases of them stayed in The First Affiliated Hospital of Soochow University and the rest one stayed in The First Affiliated Hospital of Soochow University Kuangtse branch.10 of these 21 patients were with AOSC.In these cases,patients were put up endoscopic sphincterotomy and balloon dilatation after intraoperative cholangiography.After bile duct stone removal,we tried to use “Hexie” titanium clips to stop blooding for these who showed capillary hemorrhage obvisely within EST and EPBD.After the operation,these patients were fasted and treated with other methods including acid suppression,antiinflammatory,ENBD and other methods to prevent related complications.We focused if these patients would show clinical manifestation of postoperative hemorrhage,including melena,haematemesis or others.At the same time,we monitored vital signs such as heart rate and blood pressure.We also monitored complete blood counts,blood coagulation and so on for some of these ceases.We transferred blood if necessary.Results:All these operations of bile duct stone removal were sucessesful,without related complications.These operations on the 21 petients consumed 25 “Hexie” titanium clips and the average time of placing a single one clip is 77.0±27.6s and 87.5%(21/24)clippings costed less than 120 s..22 in these 25 clips achieved the desired hemostatic effect.2 in all cases were put at the wrong place.One case influenced the pancreatic duct and was removed by snare excision.The another one did not show negative effects so we left it in situ.Two cases showed delayed hemorrhage,one haematemesis and both bloody nasobiliary drainage.These two cases both associated with AOSC.We can see obvious oozing of blood at second endoscopic views.One case were treated with “Hexie” titanium clips,another one was found too hard to clip a second “Hexie” titanium clip and both were treated with onservative treatment.Both of them stopped blooding finally.Conclusions:The application of “Hexie” titanium clips in curing hemorrhage after ERCP on choledocholithiasis is effective and feasible.AOSC may be one of the risk factors of delayed hemorrhage after using “Hexie” titanium clips to deal with blooding during ERCP.