Endoscopic hemostasis of bleeding gastric ulcer with a combination of multiple hemoclips and endoloops

Rácz, I; Kárász, Tibor; Saleh, Hussam

doi:10.1016/j.gie.2008.04.039

Cited by 7 publications

(3 citation statements)

References 9 publications

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“…The use of TIPSS is limited if there is portal vein thrombosis, a small portal vein or awkward anatomy [25,26] . The use of endoloops to obliterate gastric varices appears promising, but there are only few data documenting its efficacy [27] . The use of the Sengstaken-Blakemore tube is considered by many a futile exercise and is generally used as a last resort [28] .…”

Section: Discussionmentioning

confidence: 99%

Efficacy, Complications and Clinical Outcomes of Endoscopic Sclerotherapy with N-Butyl-2-Cyanoacrylate for Bleeding Gastric Varices

Fry

Neumann

Olano

et al. 2008

Dig Dis

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Background: Bleeding gastric varices (BGV) are a severe complication of portal hypertension. Although the obliteration of gastric varices using cyanoacrylate has been shown effective to eradicate gastric varices, there are still few data available on its effectiveness for acutely BGV, cyanoacrylate-related complications and follow-up. Aims: To report on the feasibility, efficacy and outcomes of N-buytl-2-cyanoacrylate sclerotherapy in patients with BGV. Methods: This is a retrospective cohort study of consecutive patients who were evaluated for BGV at University of Magdeburg Medical Center. Data abstracted for analysis from the prospectively collected database included patient’s demographics, etiology of gastric varices, Child-Pugh score, effectiveness of endoscopic treatment, clinical and endoscopic follow-up. Immediate hemostasis was defined as visible and clinical arrest of bleeding. The following were considered as potential complications of the procedure: aspiration, fever, worsening hemorrhage due to the sclerotherapy and systemic embolization of cyanoacrylate. Results: 33 patients (17 F, 16 M; mean age 54 years, range 18–81) with BGV (29 had active bleeding and 4 had stigmata of recent bleeding) underwent endoscopic injections of N-butyl-2-cyanoacrylate for hemostasis over a 5-year period. Mean follow-up: 9 months (range: 1 month to 5 years). Initial hemostasis was achieved in 88%. Treatment-related complications occurred in 5 (15.1%), the most common being deep ulcerations, which also resulted in recurrent bleeding. One patient presented with distal cyanoacrylate embolization. During long-term follow-up, 6 patients died, 5 as a consequence of the underlying liver disease and 1 as a consequence of complications due to systemic cyanoacrylate embolization. Conclusions: N-butyl-2-cyanoacrylate sclerotherapy is highly effective for the treatment of BGV, with rare complications occurring both acutely and in the long term.

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Section: Discussionmentioning

confidence: 99%

Efficacy, Complications and Clinical Outcomes of Endoscopic Sclerotherapy with N-Butyl-2-Cyanoacrylate for Bleeding Gastric Varices

Fry

Neumann

Olano

et al. 2008

Dig Dis

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“…The lesion generally sloughs off with time because of local tissue necrosis, and the loop falls off thereafter. Detachable snares have also been shown in limited reports to be useful for refractory ulcer bleeding 50,51 and bleeding due to submucosal tumors. 52 Although not studied, logic would suggest that they might be used for bleeding polyps when resection may not be safe because of coagulopathy or other extenuating circumstances.…”

Section: Detachable Snaresmentioning

confidence: 99%

Mechanical Hemostasis Techniques in Nonvariceal Upper Gastrointestinal Bleeding

Brock

Rockey

2015

Gastrointestinal Endoscopy Clinics of North America

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“…In our study, seven patients who received rescue endoscopic bleeding control using CDS had been treated using hemoclips for previous endoscopic hemostasis. Rácz et al suggested that the combined cliploop intervention can act as an effective "bridging-like" hemostasis by covering the ulcer base during the most risky period for severe rebleeding [7]. In our study, the CDS method was ineffective for the patient with a huge gastric ulcer.…”

mentioning

confidence: 50%

Rescue endoscopic bleeding control for nonvariceal upper gastrointestinal hemorrhage using clipping and detachable snaring

Lee

Kim²,

Seol

et al. 2013

Endoscopy

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Nonvariceal upper gastrointestinal (UGI) bleeding recurs after appropriate endoscopic therapy in 10 % - 15 % of cases. The mortality rate can be as high as 25 % when bleeding recurs, but there is no consensus about the best modality for endoscopic re-treatment. The aim of this study was to evaluate clipping and detachable snaring (CDS) for rescue endoscopic control of nonvariceal UGI hemorrhage. We report a case series of seven patients from a Korean tertiary center who underwent endoscopic hemostasis using the combined method of detachable snares with hemoclips. The success rate of endoscopic hemostasis with CDS was 86 %: six of the seven patients who had experienced primary endoscopic treatment failure or recurrent bleeding after endoscopic hemostasis were treated successfully. In conclusion, rescue endoscopic bleeding control by means of CDS is an option for controlling nonvariceal UGI bleeding when no other method of endoscopic treatment for recurrent bleeding and primary hemostatic failure is possible.

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Endoscopic hemostasis of bleeding gastric ulcer with a combination of multiple hemoclips and endoloops

Cited by 7 publications

References 9 publications

Efficacy, Complications and Clinical Outcomes of Endoscopic Sclerotherapy with N-Butyl-2-Cyanoacrylate for Bleeding Gastric Varices

Efficacy, Complications and Clinical Outcomes of Endoscopic Sclerotherapy with N-Butyl-2-Cyanoacrylate for Bleeding Gastric Varices

Mechanical Hemostasis Techniques in Nonvariceal Upper Gastrointestinal Bleeding

Rescue endoscopic bleeding control for nonvariceal upper gastrointestinal hemorrhage using clipping and detachable snaring

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