Successful hemostasis using a self-assembling peptide hydrogel for bleeding after endoscopic papillary large-balloon dilation.

Adverse bleeding events can occur after endoscopic papillary large-balloon dilation (EPLBD) [1], though not as frequently as after endoscopic sphincterotomy. Post-EPLBD bleeding often originates from sites deeper than the bile duct orifice, such as lacerations of the bile duct wall, and the origin of bleeding may not be identified; therefore, it is often difficult to stop the bleeding. A novel self-assembling peptide hydrogel (PuraStat; 3-D Matrix, Tokyo, Japan) was recently developed as a hemostatic agent [2] [3] [4]. We present a case of hemostasis of massive post-EPLBD bleeding achieved with this hydrogel.