Published online Feb 15, 2000. doi: 10.3748/wjg.v6.i1.53
Revised: November 2, 1999
Accepted: November 18, 1999
Published online: February 15, 2000
AIM: To evaluate the efficacy of endoscopic hemoclip in the t reatment of bleeding peptic ulcer.
METHODS: Totally, 40 patients with F1a and F1b hemorrhagic activity of peptic ulcers were enrolled in this uncontrolled prospective study for e ndoscopic hemoclip treatment. We used a newly developed rotatable clip-device for the application of hemoclip (MD850) to stop bleeding. Endoscopy was repeated if there was any sign or suspicion of rebleeding, and re-clipping was performed if necessary and feasible.
RESULTS: Initial hemostatic rate by clipping was 95%, and rebl eeding rate was only 8%. Ultimate hemostatic rates were 87%, 96%, and 93% in the F1a and F1b subgroups, and total cases, respectively. In patients with shock on admission, hemoclipping achieved ultimate hemostasis of 71% and 83% in F1a and F1b subgroups, respectively. Hemostasis reached 100% in patients without shock regardless of hemorrhagic activity being F1a or F1b. The average number of clips used per case was 3.0 (range 2-5). Spurting bleeders required more clips on av erage than did oozing bleeders (3.4 versus 2.8). We observed no obvious co mplications, no tissue injury, or impairment of ulcer healing related to hemocli pping.
CONCLUSION: Endoscopic hemoclip placement is an effective and safe method. With the improvement of the clip and application device, the procedu re has become easier and much more efficient. Endoscopic hemoclipping deserves further study in the treatment of bleeding peptic ulcers.