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Effect of preventive closure of the frenulum after endoscopic papillectomy: A prospective pilot study
Author(s) -
Kagawa Koichi,
Kubota Kensuke,
Kurita Yusuke,
Takagi Yuri,
Ishii Ken,
Hasegawa Sho,
Iwasaki Akito,
Sato Takamitsu,
Fujita Yuji,
Kato Shingo,
Watanabe Seitaro,
Sekino Yusuke,
Hosono Kunihiro,
Nakajima Atsushi
Publication year - 2020
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.14922
Subject(s) - medicine , surgery , clipping (morphology) , perforation , prospective cohort study , incidence (geometry) , closure (psychology) , pancreatitis , clips , market economy , philosophy , linguistics , materials science , physics , economics , optics , punching , metallurgy
Abstract Background and Aim The usefulness of preventive closure of the frenulum after endoscopic papillectomy (EP) could reduce bleeding. The feasibility and safety of clipping were evaluated in this prospective pilot study. Methods This study involved 40 consecutive patients who underwent preventive closure of the frenulum by clipping just after EP. The outcome data were compared with those of the previous 40 patients in whom no preemptive closure had been performed (no‐closure group) (UMIN000014783). Additionally, the bleeding sites were examined. Results The clipping procedure was successful in all patients. As compared to the no‐closure group, the rate of bleeding ( P = 0.026) and period of hospital stay ( P < 0.001) were significantly reduced in the closure group. There was no difference in the procedure time between the two groups. Furthermore, the incidence rates of pancreatitis and perforation were comparable in the two groups. The bleeding was noted in the frenulum area rather than at any other site in 90.9% of cases. Conclusion Preventive closure of the frenulum after EP is an effective, safe, rational, and economical method to reduce the incidence of delayed bleeding, without prolonging the procedure time or increasing the risk of post‐procedure pancreatitis perforation.