Endoscopic closure of duodenal perforations by using an over-the-scope clip: a randomized, controlled porcine study

Renteln, Daniel von; Rudolph, H.-U.; Schmidt, Arthur; Vassiliou, Melina C.; Caca, Karel

doi:10.1016/j.gie.2009.07.006

Cited by 56 publications

(42 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Very small lesions could eventually be closed using conventional endoclips, although the amount of gripped tissue is limited therefore compromising success. Animal studies could prove full thickness closure of the defects using OTSC [19] and mostly one clip was sufficient. The limitation of the OTSC size in upper GI endoscopy is the upper esophageal sphincter; within the colon, the largest clip, i.e.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic Closure of Iatrogenic Gastrointestinal Tract Perforations with the Over-the-Scope Clip

Gubler

Bauerfeind²

2012

Digestion

View full text Add to dashboard Cite

Background: Newer techniques such as mucosal resection, submucosal dissection and risky polypectomy will probably lead to increasing numbers of iatrogenic perforations. Reliable immediate closure of these lesions would increase safety and acceptance of the interventions. Methods: All acute directly observed perforations during diagnostic or therapeutic endoscopy were treated by the application of an over-the-scope clip. All consecutive patients from 2009 to August 2011 were followed in our tertiary referral center. The main outcome was technically successful closure of the perforation during endoscopy with a subsequent clinical observation for 24 h. Results: During the observation period, acute perforation occurred in 14 patients. All but 1 patient had technically successful treatment. Due to persistent abdominal pain, 3 patients had to be sent to the theater for laparoscopic evaluation after colon perforation. These 3 lesions were proven to be sealed and no resection of the colon was indicated. One patient with gastric adenocarcinoma had to be resected subtotally following endoscopic mucosal resection. Hospital stay ranged from 2 to 21 days. Conclusion: Directly observed perforations up to 30 mm diameter during endoscopy should be treated by deploying an over-the-scope clip. Endoscopists should be encouraged to be trained and to use over-the-scope clips in the stomach, duodenum and colon.

show abstract

Section: Discussionmentioning

confidence: 99%

Endoscopic Closure of Iatrogenic Gastrointestinal Tract Perforations with the Over-the-Scope Clip

Gubler

Bauerfeind²

2012

Digestion

View full text Add to dashboard Cite

show abstract

“…The median procedure time was 15 min (IQR [11][12][13][14][15][16][17][18][19][20][21][22]. Full-thickness resections produced complete gastric wall defects in 3/6 (50%) cases.…”

Section: Resultsmentioning

confidence: 99%

Endoscopic Full-Thickness Resection of Submucosal Gastric Tumors

et al. 2012

Self Cite

View full text Add to dashboard Cite

show abstract

“…The use of these OTSC clips is limited in duodenum; however, there are reports in animal models (2) and clinical case series (3-5) supporting its efficacy. We believe that OTSC clips are useful in the closure of duodenal perforations caused by interventional endoscopy.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic closure of duodenal perforation with an over-the-scope clip during endoscopic ultrasound-guided cholangiopancreatography

Salord

Gornals

Maisterra

et al. 2012

Rev. esp. enferm. dig.

View full text Add to dashboard Cite

INTRODUCTIONDuodenal perforations are a rare complication during interventional endoscopy. Their mortality is high, and the treatment in most cases is surgical.We report a case of duodenal perforation (type I, Stapfer) (1) during an interventional endoscopic ultrasound (EUS) procedure resolved using an over-the-scope clip called OTSC®. CASE REPORTA 74-year-old woman presented obstructive jaundice. Computed tomography revealed a pancreatic head tumor with dilatation of the common bile duct (CBD) and pulmonary metastases. Biliary drainage by ERCP was indicated.Papilla had tumoral signs of infiltration. Cannulation was not achieved after several attempts with a papillotome. We accessed the distal CBD after performing a pre-cut, but the guidewire could not pass deeply. After replacing the duodenoscope with a linear echoendoscope with the intention of performing biliary drainage guided by EUS, a 10 mm duodenal perforation (type I, Stapfer) was visualized in the posterior wall of the duodenal bulb (Fig. 1A) Vol. 104. N.°9, pp. 489-490, 2012 Fig. 1. A. Duodenal perforation during biliary drainage guided by EUS. B. Endoscopic closure using an over-the-scope clip (OTSC). PICTURES IN DIGESTIVE PATHOLOGY

show abstract

Endoscopic closure of duodenal perforations by using an over-the-scope clip: a randomized, controlled porcine study

Cited by 56 publications

References 35 publications

Endoscopic Closure of Iatrogenic Gastrointestinal Tract Perforations with the Over-the-Scope Clip

Endoscopic Closure of Iatrogenic Gastrointestinal Tract Perforations with the Over-the-Scope Clip

Endoscopic Full-Thickness Resection of Submucosal Gastric Tumors

Endoscopic closure of duodenal perforation with an over-the-scope clip during endoscopic ultrasound-guided cholangiopancreatography

Contact Info

Product

Resources

About