case_images: PMC10911785_01
case_images: Endoscopic retrograde cholangiopancreatography (ERCP). ERCP was performed using the PF technique, and a biliary stent was inserted (a, b). Oozing bleeding was present and persisted from the site of precut papillotomy, and hemostasis treatment was attempted. TDM-621 (3 mL) was applied to the bleeding site through a dedicated catheter (c), and complete hemostasis was achieved (d). Emergency ERCP revealed oozing bleeding between the papilla and the stent (e). As the point of bleeding was difficult to identify, TDM-621 (3 mL) was applied to the bleeding site through a dedicated endoscopic catheter (f), which led to the bleeding volume being suppressed and to the bleeding point being identified (g). Hemostasis was subsequently achieved using an endoscopic hemoclip (h).
case_images: crg-2024-0018-0001-536620_F01.jpg
case_images: PMC10911785_02_crg-2024-0018-0001-536620_F01.jpg
case_images: F1
case_images: Emergency ERCP revealed oozing bleeding between the papilla and the stent (Fig. 1e). As the point of bleeding was difficult to identify, TDM-621 (3 mL) was applied to the bleeding site through a dedicated endoscopic catheter (Fig. 1f), which led to the bleeding volume being suppressed and to the bleeding point being identified (Fig. 1g). Hemostasis was subsequently achieved with an endoscopic hemoclip (Fig. 1h).
case_images: PMC10911785_02
case_images: Endoscopic retrograde cholangiopancreatography (ERCP). ERCP was performed using the PF technique, and a biliary stent was inserted (a, b). Oozing bleeding was present and persisted from the site of precut papillotomy, and hemostasis treatment was attempted. TDM-621 (3 mL) was applied to the bleeding site through a dedicated catheter (c), and complete hemostasis was achieved (d). Emergency ERCP revealed oozing bleeding between the papilla and the stent (e). As the point of bleeding was difficult to identify, TDM-621 (3 mL) was applied to the bleeding site through a dedicated endoscopic catheter (f), which led to the bleeding volume being suppressed and to the bleeding point being identified (g). Hemostasis was subsequently achieved using an endoscopic hemoclip (h).
case_images: crg-2024-0018-0001-536620_F01.jpg
case_images: PMC10911785_02_crg-2024-0018-0001-536620_F01.jpg
case_images: F1
case_images: Emergency ERCP revealed oozing bleeding between the papilla and the stent (Fig. 1e). As the point of bleeding was difficult to identify, TDM-621 (3 mL) was applied to the bleeding site through a dedicated endoscopic catheter (Fig. 1f), which led to the bleeding volume being suppressed and to the bleeding point being identified (Fig. 1g). Hemostasis was subsequently achieved with an endoscopic hemoclip (Fig. 1h).
case_images: PMC10911785_03
case_images: Endoscopic retrograde cholangiopancreatography (ERCP). ERCP was performed using the PF technique, and a biliary stent was inserted (a, b). Oozing bleeding was present and persisted from the site of precut papillotomy, and hemostasis treatment was attempted with TDM-621 (3 mL) applied to the bleeding site through a dedicated catheter (c), and complete hemostasis was achieved (d). ERCP was performed using the PF technique, and SBDC was achieved, but oozing bleeding was present and persisted from the site of precut papillotomy and hemostasis treatment was attempted (e, f) with TDM-621 (3 mL) applied to the bleeding site through a dedicated catheter (g), and a biliary stent was inserted after complete hemostasis with TDM-621 (h).
case_images: crg-2024-0018-0001-536620_F02.jpg
case_images: PMC10911785_04_crg-2024-0018-0001-536620_F02.jpg
case_images: F2
case_images: ERCP was performed using the PF technique, and SBDC was achieved, but oozing bleeding was present and persisted from the site of precut papillotomy and hemostasis treatment was attempted (Fig. 2e, f) with TDM-621 (3 mL) applied to the bleeding site through a dedicated catheter (Fig. 2g), and a biliary stent was inserted after complete hemostasis with TDM-621 (Fig. 2h).
case_images: PMC10911785_04
case_images: Endoscopic retrograde cholangiopancreatography (ERCP). ERCP was performed using the PF technique, and a biliary stent was inserted (a, b). Oozing bleeding was present and persisted from the site of precut papillotomy, and hemostasis treatment was attempted with TDM-621 (3 mL) applied to the bleeding site through a dedicated catheter (c), and complete hemostasis was achieved (d). ERCP was performed using the PF technique, and SBDC was achieved, but oozing bleeding was present and persisted from the site of precut papillotomy and hemostasis treatment was attempted (e, f) with TDM-621 (3 mL) applied to the bleeding site through a dedicated catheter (g), and a biliary stent was inserted after complete hemostasis with TDM-621 (h).
case_images: crg-2024-0018-0001-536620_F02.jpg
case_images: PMC10911785_04_crg-2024-0018-0001-536620_F02.jpg
case_images: F2
case_images: ERCP was performed using the PF technique, and SBDC was achieved, but oozing bleeding was present and persisted from the site of precut papillotomy and hemostasis treatment was attempted (Fig. 2e, f) with TDM-621 (3 mL) applied to the bleeding site through a dedicated catheter (Fig. 2g), and a biliary stent was inserted after complete hemostasis with TDM-621 (Fig. 2h).
case_images: PMC10911785_05
case_images: Endoscopic retrograde cholangiopancreatography (ERCP). ERCP was performed using the PF technique, and SBDC was successful (a). Although oozing bleeding was present, EST was performed followed by stone extraction using balloon catheter (b). Oozing bleeding was present and persisted from the papilla, and hemostasis treatment was attempted with TDM-621 (3 mL) applied to the bleeding site through a dedicated catheter (c), and complete hemostasis was achieved (d). ERCP was performed using the PF technique, and a biliary stent was inserted (e, f). The oozing bleeding from the papilla was shown to persist; thus hemostasis treatment was attempted with TDM-621 (3 mL) applied to the bleeding site through a dedicated catheter (g), and complete hemostasis was achieved (h).
case_images: crg-2024-0018-0001-536620_F03.jpg
case_images: PMC10911785_06_crg-2024-0018-0001-536620_F03.jpg
case_images: F3
case_images: Since acute cholangitis developed during her clinical course, ERCP was performed using the PF technique, and a biliary stent was inserted (Fig. 3e, f). Oozing bleeding occurred at the site of precut papillotomy, and hemostasis treatment was attempted with TDM-621 (3 mL) applied to the bleeding site through a dedicated catheter (Fig. 3g), and complete hemostasis was achieved (Fig. 3h).
case_images: PMC10911785_06
case_images: Endoscopic retrograde cholangiopancreatography (ERCP). ERCP was performed using the PF technique, and SBDC was successful (a). Although oozing bleeding was present, EST was performed followed by stone extraction using balloon catheter (b). Oozing bleeding was present and persisted from the papilla, and hemostasis treatment was attempted with TDM-621 (3 mL) applied to the bleeding site through a dedicated catheter (c), and complete hemostasis was achieved (d). ERCP was performed using the PF technique, and a biliary stent was inserted (e, f). The oozing bleeding from the papilla was shown to persist; thus hemostasis treatment was attempted with TDM-621 (3 mL) applied to the bleeding site through a dedicated catheter (g), and complete hemostasis was achieved (h).
case_images: crg-2024-0018-0001-536620_F03.jpg
case_images: PMC10911785_06_crg-2024-0018-0001-536620_F03.jpg
case_images: F3
case_images: Since acute cholangitis developed during her clinical course, ERCP was performed using the PF technique, and a biliary stent was inserted (Fig. 3e, f). Oozing bleeding occurred at the site of precut papillotomy, and hemostasis treatment was attempted with TDM-621 (3 mL) applied to the bleeding site through a dedicated catheter (Fig. 3g), and complete hemostasis was achieved (Fig. 3h).