Risk factor of bleeding after endoscopic sphincterotomy in average risk patients

  • Sang Soo Bae
  • Dong Wook LeeEmail author
  • Jimin Han
  • Ho Gak Kim



For therapeutic endoscopic retrograde cholangiopancreatography (ERCP), endoscopic sphincterotomy (ES) is necessary but it can lead to complications such as bleeding. Thus, we investigated the risk factors of post-ES bleeding in average risk patients.


We retrospectively reviewed the medical records of patients who had been treated for ERCP between April 2006 and March 2013. The length of the ES incision was defined as minimal (up to proximal hooding fold), medium (between minimal and full length), and full (up to superior margin of sphincter opening). Exclusion criteria were as follows: if performed precut sphincterotomy or balloon dilatation, patients having altered anatomy or anticoagulant medications.


A total of 3620 patients underwent ERCP and 1121 patients who underwent biliary ES were enrolled. Post-ES bleeding occurred in 108 of 1121 patients (9.6%) and mostly minor bleeding (94 patients, 87%). Length of ES was the only risk factor for post-ES bleeding in multivariate analysis. Complete hemostasis was achieved by endoscopic modalities and no serious complication developed after hemostasis.


In average risk patients, length of ES was independent risk factor for post-ES bleeding and endoscopic hemostasis was safe and effective.


Endoscopic retrograde cholangiopancreatography Endoscopic sphincterotomy Bleeding 


Compliance with ethical standards


Sang Soo Bae, Dong Wook Lee, Jimin Han, and Ho Gak Kim have no conflicts of interest or financial ties to disclosure.


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© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Division of Gastroenterology and Hepatology, Department of Internal MedicineCatholic University of Daegu School of MedicineDaeguSouth Korea

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