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Self-assembled peptide gel presents a promising, safe option to reduce delayed bleeding post-endoscopic biliary sphincterotomy, potentially improving gastrointestinal procedural outcomes.
To assess the challenging case of delayed bleeding following endoscopic biliary sphincterotomy (ES), Tadahisa Inoue et al. investigated the efficacy of a newly developed self-assembled peptide (SAP) gel in reducing the risk of delayed ES bleeding in patients who achieved spontaneous hemostasis post-surgery.
This comprehensive study published in the Journal of Gastroenterology and Hepatology involved 1507 eligible patients. It compared the incidence of delayed bleeding and other adverse events excluding bleeding between two groups: patients treated with the self-assembling peptide (SAP group) and those who underwent observation following spontaneous hemostasis after intraoperative ES (placebo group). Propensity score matching balanced the groups for precise comparison.
Results pointed to a noteworthy reduction in delayed ES bleeding rates among patients treated with SAP (0.9%) compared to the control group (3.8%, P = 0.044). Furthermore, the incidence of non-bleeding adverse events did not significantly differ between the SAP group (2.4%) and controls (3.8%).
The use of SAP was associated with a decreased risk of delayed bleeding (odds ratio 0.35, 95% confidence interval 0.13–0.98, P = 0.047) as indicated by the multivariable analysis.
This research underscores the potential of SAP gel as a straightforward and safe intervention to mitigate delayed bleeding complications after ES.
Journal of Gastroenterology and Hepatology
Prophylactic use of a self-assembling peptide hydrogel for preventing delayed bleeding after endoscopic sphincterotomy: A propensity score-matched analysis
Tadahisa Inoue et al.
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