Dennis M Jensen1, Gustavo A Machicado. 1. Center for Ulcer Research and Education, Hemostasis Research Group, CURE Digestive Diseases Research Center, VA Greater Los Angeles Healthcare System, and David Geffen School of Medicine at UCLA, Los Angeles, California CA 90073-1003, USA.
Abstract
BACKGROUND: Several different hemoclips are marketed for endoscopic hemostasis of nonvariceal upper GI (UGI) bleeding. No previous reports have compared success rates of clip deployment onto bases of chronic gastric ulcers (GUs), clip retention rates, or their influence on ulcer healing. OBJECTIVES: For the treatment of chronic GUs, to compare 3 different hemoclips with multipolar electrocoagulation (MPEC) and control. DESIGN: Randomized, controlled study. SUBJECTS: Seven adult dogs with prehepatic portal hypertension had GUs created by rubber band ligation. Animals received oral proton pump inhibitors daily and underwent weekly endoscopies to quantitate clip retention and ulcer healing. INTERVENTIONS: One week after banding, 10 chronic ulcers were randomized in pairs to control (no endoscopic treatment), MPEC, or different hemoclips (QuickClip2 [QC], TriClip [TC], or Resolution Clip [RC]). MAIN OUTCOME MEASUREMENTS: Times and success of hemoclip deployment, clip retention rates, and ulcer healing rates on weekly endoscopies. RESULTS: Success rates of clip deployment were 100% for the RC, 93.1% for the TC, and 83.3% for the QC. Clip retention rates were significantly higher with the RC than the QC or TC at 1 to 3 weeks. Retained clips did not delay GU healing compared with MPEC or control. CONCLUSIONS: Hemoclipping time was similar with all 3 clips; the RC was retained significantly longer than the QC or TC, hemoclips did not delay ulcer healing compared with control or MPEC, and all 3 hemoclips were safe and no complications such as bleeding and weight loss were noted.
BACKGROUND: Several different hemoclips are marketed for endoscopic hemostasis of nonvariceal upper GI (UGI) bleeding. No previous reports have compared success rates of clip deployment onto bases of chronic gastric ulcers (GUs), clip retention rates, or their influence on ulcer healing. OBJECTIVES: For the treatment of chronic GUs, to compare 3 different hemoclips with multipolar electrocoagulation (MPEC) and control. DESIGN: Randomized, controlled study. SUBJECTS: Seven adult dogs with prehepatic portal hypertension had GUs created by rubber band ligation. Animals received oral proton pump inhibitors daily and underwent weekly endoscopies to quantitate clip retention and ulcer healing. INTERVENTIONS: One week after banding, 10 chronic ulcers were randomized in pairs to control (no endoscopic treatment), MPEC, or different hemoclips (QuickClip2 [QC], TriClip [TC], or Resolution Clip [RC]). MAIN OUTCOME MEASUREMENTS: Times and success of hemoclip deployment, clip retention rates, and ulcer healing rates on weekly endoscopies. RESULTS: Success rates of clip deployment were 100% for the RC, 93.1% for the TC, and 83.3% for the QC. Clip retention rates were significantly higher with the RC than the QC or TC at 1 to 3 weeks. Retained clips did not delay GU healing compared with MPEC or control. CONCLUSIONS: Hemoclipping time was similar with all 3 clips; the RC was retained significantly longer than the QC or TC, hemoclips did not delay ulcer healing compared with control or MPEC, and all 3 hemoclips were safe and no complications such as bleeding and weight loss were noted.
Authors: J Y Lau; J J Sung; K K Lee; M Y Yung; S K Wong; J C Wu; F K Chan; E K Ng; J H You; C W Lee; A C Chan; S C Chung Journal: N Engl J Med Date: 2000-08-03 Impact factor: 91.245
Authors: C P Swain; D W Storey; S G Bown; J Heath; T N Mills; P R Salmon; T C Northfield; J S Kirkham; J P O'Sullivan Journal: Gastroenterology Date: 1986-03 Impact factor: 22.682
Authors: Heiko Pohl; Ian S Grimm; Matthew T Moyer; Muhammad K Hasan; Douglas Pleskow; B Joseph Elmunzer; Mouen A Khashab; Omid Sanaei; Firas H Al-Kawas; Stuart R Gordon; Abraham Mathew; John M Levenick; Harry R Aslanian; Fadi Antaki; Daniel von Renteln; Seth D Crockett; Amit Rastogi; Jeffrey A Gill; Ryan J Law; Pooja A Elias; Maria Pellise; Michael B Wallace; Todd A Mackenzie; Douglas K Rex Journal: Gastroenterology Date: 2019-03-15 Impact factor: 22.682
Authors: Eric Wee; Mathew Philip Sachin; Uthamanand Chinnappa; Su Chang; Cherng Hann Benjamin Yip Journal: Dig Dis Sci Date: 2015-03-31 Impact factor: 3.199
Authors: M Camus; D M Jensen; G V Ohning; T O Kovacs; K A Ghassemi; R Jutabha; G A Machicado; G S Dulai; O J Hines Journal: Endoscopy Date: 2013-04-24 Impact factor: 10.093