Abstract :It was not rare to have post-sphincterotomy bleeding (PSB) after endoscopic sphincterotomy (EST)
in endoscopic retrograde cholangiopancreatography (ERCP). Severe PSB will be a challenge to treat
endoscopically with traditional hemostasis methods. Some physicians had placed self-expandable
fully-covered metallic stents (FCMS) to treat severe PSB with satisfactory results. We tried to place
multiple plastic stents to make the similar tamponade effect as it did with FCMS. Two old female
patients had severe delayed PSB after endoscopic sphincterotomy. Both could not have hemostasis
after traditional injectional therapy with epinephrine. We then placed 3 plastic stents in one and
2 stents in the other patient and achieved immediate hemostasis without complication. Both of
them had no recurrent bleeding during follow-up. The 2 patients had stents removed 2 weeks later
respectively and had no sequela. Severe PSB may be treated effectively with multiple plastic stents
placement as with FCMS.