Background and Aim: Endoscopic retrograde cholangiopancreatography (ERCP) and sphincterotomy
(EST) are standard treatments for choledocholithiasis. However, 10% of post-EST bleeding was
reported. Currently, there are no effective methods or medications for the prevention of
post-EST bleeding. This study aimed to investigate whether the local administration of TXA
and sucralfate can reduce the post-EST bleeding event.
Methods: This is a randomized clinical trial. Patients with choledocholithiasis scheduled for
ERCP with EST at National Cheng Kung University Hospital were enrolled. The study will
recruit 60 patients. After randomization, 30 patients will be classified into the
intervention group and 30 into the control group. The participants will receive standard ERCP
and EST for common bile duct stone removal. If immediate polypectomy bleeding occurs, the
investigators will apply standard endoscopic therapy by either local injection of diluted
epinephrine or heater probe coagulation. After then, the investigators will spray 2g of
sucralfate powder and 1g of tranexamic acid through duodenoscopy precisely on the post-EST
wound in the intervention group. All enrolled patients will be monitored for delayed bleeding
for 14 days after the ERCP.