S146 Use of Novel Agent Purastat® for Post Sphincterotomy Bleeding

Introduction: Endoscopic sphincterotomy is commonly performed during endoscopic retrograde cholangiopancreatography. Despite being performed by expert endoscopists, endoscopic sphincterotomy is associated with adverse events such as bleeding and perforation. The incidence of post sphincterotomy bleed has been reported to be 1%-3%. PuraStat® is a new synthetic hemostatic gel being used for the prophylaxis and treatment of gastrointestinal bleeding. To date, there are no published reports on the use of PuraStat® for post sphincterotomy bleeding. We aim to report the use and outcomes of PuraStat® for post sphincterotomy bleeding. Methods: We conducted a retrospective review of medical records from 2 institutions. All patients who underwent endoscopic sphincterotomy for which PuraStat® was used alongside other hemostatic methods for the treatment of post-sphincterotomy bleeding were included. The aim of this study is to report on the indication, procedural and technical parameters and efficacy and safety of PuraStat® for post-sphincterotomy hemorrhage. Results: A total of 11 patients met our inclusion criteria; 55% of patients were women and mean age was 59 years; 18% of patients had significant renal dysfunction (GFR <60) and 9% had abnormal platelets at the time of intervention; 82% of patients had intraprocedural/immediate bleeding during sphincterotomy; 18% of the patients required hospitalization due to immediate bleeding. A variety of hemostatic methods were used with 36% of the patient requiring bipolar cautery. Eighty-two percent of the patients had complete cessation of the bleeding during index procedure after PuraStat® application. None of the patients experienced recurrent (<2 weeks) bleeding after hemostatic agent use. Conclusion: Our study demonstrates the efficacy of PuraStat® in the management of post-sphincterotomy bleeding and none of the patients experienced recurrent bleeding after its use. The use of this novel agent proves to be safe and efficacious when used alongside other hemostatic methods. Larger scale multicenter studies are required to further validate these findings.