ArticleTherapeutic advances in gastroenterology2026
Topical tranexamic acid and sucralfate prevent delayed bleeding after endoscopic sphincterotomy: a randomized controlled trial (with video).
Article in Therapeutic advances in gastroenterology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06107504 (Prevention of Post-sphincterotomy Bleeding by Endoscopic Tranexamic Acid and Sucralfate Administration), which is not on this map. Not yet cited in PubMed.
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Prevention of Post-sphincterotomy Bleeding by Endoscopic Tranexamic Acid and Sucralfate Administration: A Randomized Controlled Trial
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11 authors.
Funding
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Abstract
Background: Endoscopic sphincterotomy (EST) is a standard treatment for choledocholithiasis. However, this approach carries a risk of delayed bleeding, which occurs in 2%-12% of all patients within 14 days postoperatively. Despite this risk, few effective measures are currently available for preventing delayed bleeding. Objectives: Tranexamic acid (TXA) is an antifibrinolytic agent that promotes hemostasis, and sucralfate is an antiulcer agent that forms a protective barrier over wounds. In this study, we investigated whether topical TXA and sucralfate application on post-EST wounds reduces the risk of delayed bleeding. Design: This prospective randomized controlled trial was conducted between December 2023 and December 2024 at a tertiary center. Methods: This study included patients with a naïve biliary major papilla and choledocholithiasis who were scheduled for EST. Patients who had unsuccessful common bile duct cannulation, were scheduled for biliary stent insertion without a sphincterotomy, underwent endoscopic papillary balloon dilatation instead of EST, or had any known biliary or pancreatic malignancies were excluded. The final cohort comprised 120 patients. After EST and stone removal, patients were randomized to an intervention group ( Results: Freedom from delayed bleeding within 14 days was significantly longer in the intervention group than in the control group ( Conclusion: Topical TXA and sucralfate application holds promise for preventing delayed post-EST bleeding. Trial registration: This study was registered at ClinicalTrials.gov (NCT06107504).
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