Factors associated with delayed hemorrhage after endoscopic sphincterotomy: Japanese large single-center experience
Background Hemorrhage is one of the serious adverse events of endoscopic sphincterotomy (EST). However, the risk factors for delayed hemorrhage after EST have not been clarified. The aim of this study was to examine the risk factors for delayed hemorrhage after EST. Methods Consecutive patients who...
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| Veröffentlicht in: | Journal of gastroenterology 2017-12, Vol.52 (12), p.1258-1265 |
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| creator | Ikarashi, Satoshi Katanuma, Akio Kin, Toshifumi Takahashi, Kuniyuki Yane, Kei Sano, Itsuki Yamazaki, Hajime Maguchi, Hiroyuki |
| description | Background
Hemorrhage is one of the serious adverse events of endoscopic sphincterotomy (EST). However, the risk factors for delayed hemorrhage after EST have not been clarified. The aim of this study was to examine the risk factors for delayed hemorrhage after EST.
Methods
Consecutive patients who underwent EST between January 2011 and December 2015 were analyzed retrospectively. The incidence, treatment outcomes, and risk factors for delayed hemorrhage were evaluated. Delayed hemorrhage was defined as symptomatic hemorrhage occurring 24 h after an endoscopic procedure.
Results
After analyzing 1113 patients who underwent EST, delayed hemorrhage was seen to occur in 30 (2.7%) patients. The median period before presentation of delayed hemorrhage was 2 days (range 1–6) after EST, and its severity was mild in four, moderate in 20, and severe in six patients. All patients with delayed hemorrhage received successful endoscopic hemostasis. Univariate analysis showed that delayed hemorrhage occurred more frequently in patients with hemodialysis (
p
= 0.013), heparin replacement of antithrombotic agents (
p
= 0.012), or early hemorrhage occurring just after EST (
p
|
| doi_str_mv | 10.1007/s00535-017-1347-9 |
| format | Article |
| fullrecord | <record><control><sourceid>gale_proqu</sourceid><recordid>TN_cdi_proquest_miscellaneous_1896422201</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A714583435</galeid><sourcerecordid>A714583435</sourcerecordid><originalsourceid>FETCH-LOGICAL-c463t-35550f497b3ae35580125e91f847cbebf02f0e9ae73659f0226a646bb77701053</originalsourceid><addsrcrecordid>eNp1kU1v1DAQhi0EosvCD-CCInHpJcWfccytqlo-VKmXcrYcZ7LrKrGDnRXsv-9st6CCQD5YM37e0et5CXnL6BmjVH8olCqhasp0zYTUtXlGVkxiRxnOn5MVNVLWjGl5Ql6VckcpE1S1L8kJb6VuFRcrUq6cX1IulSsl-eAW6KsfYdlWPYxuj8UWppTz1m2gcsMCuYLYp-LTHHxV5m2IHptpSdP-Y_XVzS5CgWp0GfkS4maE2kN80P2cIQeIHl6TF4MbC7x5vNfk29Xl7cXn-vrm05eL8-vay0YstVBK0UEa3QkHWLSUcQWGDWjed9ANlA8UjAMtGmWw4o1rZNN1WmvKcDNrcnqcO-f0fQdlsVMoHsYRTaZdsaw1jeSc41rW5P1f6F3a5YjuLDONoFo1T6mNG8GGOKQlO38Yas81k6oVuHykzv5B4elhCj5FGAL2_xCwo8DnVEqGwc45TC7vLaP2ELQ9Bm0xaHsI2hrUvHs0vOsm6H8rfiWLAD8CBZ_iBvKTH_136j16Z7IX</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1963075601</pqid></control><display><type>article</type><title>Factors associated with delayed hemorrhage after endoscopic sphincterotomy: Japanese large single-center experience</title><source>MEDLINE</source><source>Springer Nature - Complete Springer Journals</source><creator>Ikarashi, Satoshi ; Katanuma, Akio ; Kin, Toshifumi ; Takahashi, Kuniyuki ; Yane, Kei ; Sano, Itsuki ; Yamazaki, Hajime ; Maguchi, Hiroyuki</creator><creatorcontrib>Ikarashi, Satoshi ; Katanuma, Akio ; Kin, Toshifumi ; Takahashi, Kuniyuki ; Yane, Kei ; Sano, Itsuki ; Yamazaki, Hajime ; Maguchi, Hiroyuki</creatorcontrib><description>Background
Hemorrhage is one of the serious adverse events of endoscopic sphincterotomy (EST). However, the risk factors for delayed hemorrhage after EST have not been clarified. The aim of this study was to examine the risk factors for delayed hemorrhage after EST.
Methods
Consecutive patients who underwent EST between January 2011 and December 2015 were analyzed retrospectively. The incidence, treatment outcomes, and risk factors for delayed hemorrhage were evaluated. Delayed hemorrhage was defined as symptomatic hemorrhage occurring 24 h after an endoscopic procedure.
Results
After analyzing 1113 patients who underwent EST, delayed hemorrhage was seen to occur in 30 (2.7%) patients. The median period before presentation of delayed hemorrhage was 2 days (range 1–6) after EST, and its severity was mild in four, moderate in 20, and severe in six patients. All patients with delayed hemorrhage received successful endoscopic hemostasis. Univariate analysis showed that delayed hemorrhage occurred more frequently in patients with hemodialysis (
p
= 0.013), heparin replacement of antithrombotic agents (
p
= 0.012), or early hemorrhage occurring just after EST (
p
< 0.001). Among these, hemodialysis (OR 6.44, 95% CI 1.67–24.8;
p
= 0.007), heparin replacement (OR 3.76, 95% CI 1.42–9.98;
p
= 0.008), and early hemorrhage (OR 4.35, 95% CI 1.90–9.96;
p
< 0.001) proved to be independent risk factors for delayed hemorrhage on multivariate analysis.
Conclusions
The incidence of delayed hemorrhage after EST was 2.7%. Hemodialysis, heparin replacement, and early hemorrhage were the risk factors for delayed hemorrhage.</description><identifier>ISSN: 0944-1174</identifier><identifier>EISSN: 1435-5922</identifier><identifier>DOI: 10.1007/s00535-017-1347-9</identifier><identifier>PMID: 28478523</identifier><language>eng</language><publisher>Tokyo: Springer Japan</publisher><subject>Abdominal Surgery ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Analysis ; Biliary Tract ; Colorectal Surgery ; Complications and side effects ; Endoscopy ; Female ; Gastroenterology ; Hemodialysis ; Hemorrhage ; Hemostasis ; Hemostasis, Endoscopic - methods ; Heparin ; Heparin - administration & dosage ; Heparin - adverse effects ; Hepatology ; Humans ; Incidence ; Japan ; Male ; Medical research ; Medicine ; Medicine & Public Health ; Medicine, Experimental ; Middle Aged ; Multivariate Analysis ; Original Article—Liver ; Pancreas ; Postoperative Hemorrhage - epidemiology ; Postoperative Hemorrhage - physiopathology ; Postoperative Hemorrhage - therapy ; Renal Dialysis - adverse effects ; Renal Dialysis - methods ; Retrospective Studies ; Risk Factors ; Severity of Illness Index ; Sphincterotomy, Endoscopic - adverse effects ; Surgical Oncology ; Time Factors ; Treatment Outcome ; Young Adult</subject><ispartof>Journal of gastroenterology, 2017-12, Vol.52 (12), p.1258-1265</ispartof><rights>Japanese Society of Gastroenterology 2017</rights><rights>COPYRIGHT 2017 Springer</rights><rights>Journal of Gastroenterology is a copyright of Springer, (2017). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c463t-35550f497b3ae35580125e91f847cbebf02f0e9ae73659f0226a646bb77701053</citedby><cites>FETCH-LOGICAL-c463t-35550f497b3ae35580125e91f847cbebf02f0e9ae73659f0226a646bb77701053</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00535-017-1347-9$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00535-017-1347-9$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27903,27904,41467,42536,51297</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28478523$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ikarashi, Satoshi</creatorcontrib><creatorcontrib>Katanuma, Akio</creatorcontrib><creatorcontrib>Kin, Toshifumi</creatorcontrib><creatorcontrib>Takahashi, Kuniyuki</creatorcontrib><creatorcontrib>Yane, Kei</creatorcontrib><creatorcontrib>Sano, Itsuki</creatorcontrib><creatorcontrib>Yamazaki, Hajime</creatorcontrib><creatorcontrib>Maguchi, Hiroyuki</creatorcontrib><title>Factors associated with delayed hemorrhage after endoscopic sphincterotomy: Japanese large single-center experience</title><title>Journal of gastroenterology</title><addtitle>J Gastroenterol</addtitle><addtitle>J Gastroenterol</addtitle><description>Background
Hemorrhage is one of the serious adverse events of endoscopic sphincterotomy (EST). However, the risk factors for delayed hemorrhage after EST have not been clarified. The aim of this study was to examine the risk factors for delayed hemorrhage after EST.
Methods
Consecutive patients who underwent EST between January 2011 and December 2015 were analyzed retrospectively. The incidence, treatment outcomes, and risk factors for delayed hemorrhage were evaluated. Delayed hemorrhage was defined as symptomatic hemorrhage occurring 24 h after an endoscopic procedure.
Results
After analyzing 1113 patients who underwent EST, delayed hemorrhage was seen to occur in 30 (2.7%) patients. The median period before presentation of delayed hemorrhage was 2 days (range 1–6) after EST, and its severity was mild in four, moderate in 20, and severe in six patients. All patients with delayed hemorrhage received successful endoscopic hemostasis. Univariate analysis showed that delayed hemorrhage occurred more frequently in patients with hemodialysis (
p
= 0.013), heparin replacement of antithrombotic agents (
p
= 0.012), or early hemorrhage occurring just after EST (
p
< 0.001). Among these, hemodialysis (OR 6.44, 95% CI 1.67–24.8;
p
= 0.007), heparin replacement (OR 3.76, 95% CI 1.42–9.98;
p
= 0.008), and early hemorrhage (OR 4.35, 95% CI 1.90–9.96;
p
< 0.001) proved to be independent risk factors for delayed hemorrhage on multivariate analysis.
Conclusions
The incidence of delayed hemorrhage after EST was 2.7%. Hemodialysis, heparin replacement, and early hemorrhage were the risk factors for delayed hemorrhage.</description><subject>Abdominal Surgery</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Analysis</subject><subject>Biliary Tract</subject><subject>Colorectal Surgery</subject><subject>Complications and side effects</subject><subject>Endoscopy</subject><subject>Female</subject><subject>Gastroenterology</subject><subject>Hemodialysis</subject><subject>Hemorrhage</subject><subject>Hemostasis</subject><subject>Hemostasis, Endoscopic - methods</subject><subject>Heparin</subject><subject>Heparin - administration & dosage</subject><subject>Heparin - adverse effects</subject><subject>Hepatology</subject><subject>Humans</subject><subject>Incidence</subject><subject>Japan</subject><subject>Male</subject><subject>Medical research</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Medicine, Experimental</subject><subject>Middle Aged</subject><subject>Multivariate Analysis</subject><subject>Original Article—Liver</subject><subject>Pancreas</subject><subject>Postoperative Hemorrhage - epidemiology</subject><subject>Postoperative Hemorrhage - physiopathology</subject><subject>Postoperative Hemorrhage - therapy</subject><subject>Renal Dialysis - adverse effects</subject><subject>Renal Dialysis - methods</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Severity of Illness Index</subject><subject>Sphincterotomy, Endoscopic - adverse effects</subject><subject>Surgical Oncology</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><subject>Young Adult</subject><issn>0944-1174</issn><issn>1435-5922</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp1kU1v1DAQhi0EosvCD-CCInHpJcWfccytqlo-VKmXcrYcZ7LrKrGDnRXsv-9st6CCQD5YM37e0et5CXnL6BmjVH8olCqhasp0zYTUtXlGVkxiRxnOn5MVNVLWjGl5Ql6VckcpE1S1L8kJb6VuFRcrUq6cX1IulSsl-eAW6KsfYdlWPYxuj8UWppTz1m2gcsMCuYLYp-LTHHxV5m2IHptpSdP-Y_XVzS5CgWp0GfkS4maE2kN80P2cIQeIHl6TF4MbC7x5vNfk29Xl7cXn-vrm05eL8-vay0YstVBK0UEa3QkHWLSUcQWGDWjed9ANlA8UjAMtGmWw4o1rZNN1WmvKcDNrcnqcO-f0fQdlsVMoHsYRTaZdsaw1jeSc41rW5P1f6F3a5YjuLDONoFo1T6mNG8GGOKQlO38Yas81k6oVuHykzv5B4elhCj5FGAL2_xCwo8DnVEqGwc45TC7vLaP2ELQ9Bm0xaHsI2hrUvHs0vOsm6H8rfiWLAD8CBZ_iBvKTH_136j16Z7IX</recordid><startdate>20171201</startdate><enddate>20171201</enddate><creator>Ikarashi, Satoshi</creator><creator>Katanuma, Akio</creator><creator>Kin, Toshifumi</creator><creator>Takahashi, Kuniyuki</creator><creator>Yane, Kei</creator><creator>Sano, Itsuki</creator><creator>Yamazaki, Hajime</creator><creator>Maguchi, Hiroyuki</creator><general>Springer Japan</general><general>Springer</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7T5</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20171201</creationdate><title>Factors associated with delayed hemorrhage after endoscopic sphincterotomy: Japanese large single-center experience</title><author>Ikarashi, Satoshi ; Katanuma, Akio ; Kin, Toshifumi ; Takahashi, Kuniyuki ; Yane, Kei ; Sano, Itsuki ; Yamazaki, Hajime ; Maguchi, Hiroyuki</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c463t-35550f497b3ae35580125e91f847cbebf02f0e9ae73659f0226a646bb77701053</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Abdominal Surgery</topic><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Analysis</topic><topic>Biliary Tract</topic><topic>Colorectal Surgery</topic><topic>Complications and side effects</topic><topic>Endoscopy</topic><topic>Female</topic><topic>Gastroenterology</topic><topic>Hemodialysis</topic><topic>Hemorrhage</topic><topic>Hemostasis</topic><topic>Hemostasis, Endoscopic - methods</topic><topic>Heparin</topic><topic>Heparin - administration & dosage</topic><topic>Heparin - adverse effects</topic><topic>Hepatology</topic><topic>Humans</topic><topic>Incidence</topic><topic>Japan</topic><topic>Male</topic><topic>Medical research</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Medicine, Experimental</topic><topic>Middle Aged</topic><topic>Multivariate Analysis</topic><topic>Original Article—Liver</topic><topic>Pancreas</topic><topic>Postoperative Hemorrhage - epidemiology</topic><topic>Postoperative Hemorrhage - physiopathology</topic><topic>Postoperative Hemorrhage - therapy</topic><topic>Renal Dialysis - adverse effects</topic><topic>Renal Dialysis - methods</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Severity of Illness Index</topic><topic>Sphincterotomy, Endoscopic - adverse effects</topic><topic>Surgical Oncology</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ikarashi, Satoshi</creatorcontrib><creatorcontrib>Katanuma, Akio</creatorcontrib><creatorcontrib>Kin, Toshifumi</creatorcontrib><creatorcontrib>Takahashi, Kuniyuki</creatorcontrib><creatorcontrib>Yane, Kei</creatorcontrib><creatorcontrib>Sano, Itsuki</creatorcontrib><creatorcontrib>Yamazaki, Hajime</creatorcontrib><creatorcontrib>Maguchi, Hiroyuki</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Immunology Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of gastroenterology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ikarashi, Satoshi</au><au>Katanuma, Akio</au><au>Kin, Toshifumi</au><au>Takahashi, Kuniyuki</au><au>Yane, Kei</au><au>Sano, Itsuki</au><au>Yamazaki, Hajime</au><au>Maguchi, Hiroyuki</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Factors associated with delayed hemorrhage after endoscopic sphincterotomy: Japanese large single-center experience</atitle><jtitle>Journal of gastroenterology</jtitle><stitle>J Gastroenterol</stitle><addtitle>J Gastroenterol</addtitle><date>2017-12-01</date><risdate>2017</risdate><volume>52</volume><issue>12</issue><spage>1258</spage><epage>1265</epage><pages>1258-1265</pages><issn>0944-1174</issn><eissn>1435-5922</eissn><abstract>Background
Hemorrhage is one of the serious adverse events of endoscopic sphincterotomy (EST). However, the risk factors for delayed hemorrhage after EST have not been clarified. The aim of this study was to examine the risk factors for delayed hemorrhage after EST.
Methods
Consecutive patients who underwent EST between January 2011 and December 2015 were analyzed retrospectively. The incidence, treatment outcomes, and risk factors for delayed hemorrhage were evaluated. Delayed hemorrhage was defined as symptomatic hemorrhage occurring 24 h after an endoscopic procedure.
Results
After analyzing 1113 patients who underwent EST, delayed hemorrhage was seen to occur in 30 (2.7%) patients. The median period before presentation of delayed hemorrhage was 2 days (range 1–6) after EST, and its severity was mild in four, moderate in 20, and severe in six patients. All patients with delayed hemorrhage received successful endoscopic hemostasis. Univariate analysis showed that delayed hemorrhage occurred more frequently in patients with hemodialysis (
p
= 0.013), heparin replacement of antithrombotic agents (
p
= 0.012), or early hemorrhage occurring just after EST (
p
< 0.001). Among these, hemodialysis (OR 6.44, 95% CI 1.67–24.8;
p
= 0.007), heparin replacement (OR 3.76, 95% CI 1.42–9.98;
p
= 0.008), and early hemorrhage (OR 4.35, 95% CI 1.90–9.96;
p
< 0.001) proved to be independent risk factors for delayed hemorrhage on multivariate analysis.
Conclusions
The incidence of delayed hemorrhage after EST was 2.7%. Hemodialysis, heparin replacement, and early hemorrhage were the risk factors for delayed hemorrhage.</abstract><cop>Tokyo</cop><pub>Springer Japan</pub><pmid>28478523</pmid><doi>10.1007/s00535-017-1347-9</doi><tpages>8</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0944-1174 |
| ispartof | Journal of gastroenterology, 2017-12, Vol.52 (12), p.1258-1265 |
| issn | 0944-1174 1435-5922 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1896422201 |
| source | MEDLINE; Springer Nature - Complete Springer Journals |
| subjects | Abdominal Surgery Adolescent Adult Aged Aged, 80 and over Analysis Biliary Tract Colorectal Surgery Complications and side effects Endoscopy Female Gastroenterology Hemodialysis Hemorrhage Hemostasis Hemostasis, Endoscopic - methods Heparin Heparin - administration & dosage Heparin - adverse effects Hepatology Humans Incidence Japan Male Medical research Medicine Medicine & Public Health Medicine, Experimental Middle Aged Multivariate Analysis Original Article—Liver Pancreas Postoperative Hemorrhage - epidemiology Postoperative Hemorrhage - physiopathology Postoperative Hemorrhage - therapy Renal Dialysis - adverse effects Renal Dialysis - methods Retrospective Studies Risk Factors Severity of Illness Index Sphincterotomy, Endoscopic - adverse effects Surgical Oncology Time Factors Treatment Outcome Young Adult |
| title | Factors associated with delayed hemorrhage after endoscopic sphincterotomy: Japanese large single-center experience |
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