Thus, we decided to insert the Hemos- pray cannula inside the left stent, up to the hilum, and spray the powder while withdrawing the cannula down to the papilla (Video 1, available online at www.VideoGIE. org). Active bleeding stopped thereafter, and the patient did not experience immediate adverse events. The patient remained asymptomatic after the procedure, and follow-up examinations showed a rise of the hemoglobin level, whereas the bilirubin value remained just above normal (1.41 mg/dL). Because no curative options could be offered to the patient, she was discharged 16 days later.
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