Can prophylactic argon plasma coagulation reduce delayed post‐papillectomy bleeding? A prospective multicenter trial

• DOI: 10.1111/jgh.15186
• Publication Date: 2020-07-17T09:45:53Z
• Authors: Jae Kook Yang; Jong Jin Hyun; Tae Hoon Lee; Jun‐Ho Choi; Yun Nah Lee; Jung Wan Choe; Jin‐Seok Park; Chang‐Il Kwon; Seok Jeong; Hong Ja Kim; Jong Ho Moon; Sang‐Heum Park
• Keywords: Adult; Male; Ampulla of Vater; Argon Plasma Coagulation; Common Bile Duct Neoplasms; Adenocarcinoma; Middle Aged; Postoperative Hemorrhage; 3. Good health; Sphincterotomy, Endoscopic; 03 medical and health sciences; 0302 clinical medicine; Humans; Female; Prospective Studies; Aged

Abstract Background and Aim Endoscopic post‐papillectomy bleeding occurs in 3% to 20% of the cases, delayed is also problematic. However, there no consensus on how reduce bleeding. The aim this study was evaluate efficacy prophylactic argon plasma coagulation (APC) minimize persistence residual tumors after endoscopic papillectomy. Methods In a prospective pilot patients with benign ampullary tumors, APC group underwent at resection margin following conventional snaring Then, 24 h later papillectomy, all follow‐up duodenoscopy identify were followed up until 12 months. main outcomes (≥24 h) rate tumor rate. Results 30.8% (8/26) 21.4% (6/28) non‐APC ( P = 0.434). post‐procedure pancreatitis rates 23.1% (6/26) 35.7% (10/28), respectively 0.310). did not differ between two groups 1 month (12.5% vs 7.4%, 0.656), 3 months (4.2% 3.7%, 1.00), 6 (8.3% 0.595), (0% 1.00). There procedure‐related mortalities or serious complications. Conclusion Prophylactic may be effective reducing remnant ablation immediately papillectomy (Clinical trial registration— cris.nih.go.kr ; KCT0001955).