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Successful endoscopic sphincterotomy for choledocholithiasis in a patient with severe hemophilia A and inhibitors

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Title: Successful endoscopic sphincterotomy for choledocholithiasis in a patient with severe hemophilia A and inhibitors
Authors: Sugiura, Ryo Browse this author
Kuwatani, Masaki Browse this author →KAKEN DB
Kawakubo, Kazumichi Browse this author →KAKEN DB
Sano, Itsuki Browse this author
Kato, Shin Browse this author
Endo, Tomoyuki Browse this author
Sakamoto, Naoya Browse this author →KAKEN DB
Keywords: Endoscopic sphincterotomy
Issue Date: Jun-2018
Publisher: Springer
Journal Title: Clinical journal of gastroenterology
Volume: 11
Issue: 3
Start Page: 188
End Page: 192
Publisher DOI: 10.1007/s12328-018-0826-8
PMID: 29396835
Abstract: Endoscopic sphincterotomy (ES) is a standard procedure for bile duct stone removal. However, the safety of ES in patients with hemophilia remains unknown. We treated a 46-year-old man who had choledocholithiasis and severe hemophilia A with high-responding inhibitors during immune tolerance induction therapy. Since coagulation factor VIII inhibitors neutralize and inactivate endogenous and exogenous factor VIII, bleeding risk is higher in hemophilia A patients with inhibitors than in those without inhibitors. With adequate pre- and post-procedure monitoring of the clotting factor and supplemented clotting factor, the patient could safely undergo ES without bleeding complications. ES can be also an effective and safe first-line therapy for choledocholithiasis in patients with hemophilia and inhibitors under the condition of appropriate management.
Rights: The final publication is available at
Type: article (author version)
Appears in Collections:北海道大学病院 (Hokkaido University Hospital) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 桒谷 将城

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