Endoscopic clipping in non-variceal upper gastrointestinal bleeding treatment

Abstract

Since the earliest reports, advanced clipping systems have been developed, and it is possible to choose among many models with different structural and technical features. The main drawback of through-the-scope clips is their small size, which allows the compression of limited amounts of tissue needed for large-size vessel treatment. Therefore, the over-the-scope clip system was realized, allowing a larger and stronger mechanical compression of large tissue areas, with excellent results in achieving a definitive hemostasis in difficult cases. Many studies have analyzed the indications and efficacy of two-pronged endoclips and have shown good results for initial and permanent hemostasis. The aim of this review was to provide updated information on indications, positioning techniques, and results of clip application for endoscopic treatment of upper gastrointestinal non-variceal bleeding lesions.

Right tool for the right bleeder

“…Currently, minimising rebleeding risk of peptic ulcers remains a challenge for endoscopists. Factors predicting the risk of rebleeding include underlying patient comorbidities, active bleeding, ulcer size, ulcer location,2 operator experience and capability of different devices 3. The study was well conducted, however, there are certain nuances that we feel would add strength to the findings.…”

“…Importantly, every haemostasis device has its own strengths and limitations. Preventing rebleeding after primary endoscopic haemostasis using clips largely relies on the durability and sustainability of maintenance compression force of the clip 2. The strength of the OTSC is based on the ability to encircle a target lesion, grasp adjacent tissue and provide sustained forceful compression.…”

Effect of Implementing Nursing Protocol on clinical Outcomes of Acute Non- variceal Upper Gastrointestinal Bleeding Patients

“…The rate of bleeding peptic ulcers caused by the use of aspirin and non-steroidal anti-inflammatory drugs has increased, despite the extensive use of proton pump inhibitors to reduce the incidence of UGI bleeding in the last 15 years. Furthermore, the mortality rate hasn't changed much over the last 20 years, primarily due to population aging and the presence of comorbidities (5) . Symptoms of AUGIB include melena, hematemesis, and anaemia.…”

“…Health care providers who have continuous contact with patients and their families and have the opportunities to assess potential problem, specific care for patient and give teaching about all aspects of care (11) . Significance of the study: Acute upper gastrointestinal (UGI) bleeding represent an incidence of 100.000 population/ year, and it represents a one of most common cause of hospital admission with a markedly associated morbidity and mortality rate, especially in elderly subjects (5) . In Egypt, there are roughly 100 cases of upper gastrointestinal bleeding per 100,000 people per year.…”

Novel removable endoscopic clip: Usefulness in failure of traction method during endoscopic submucosal dissection

“…Endoscopic clips, which are widely used for hemostasis and closure [1,2], have recently been applied to other indications such as traction-assisted endoscopic submucosal dissection (ESD) [3]. Repositionable clips have been reported to be a promising option for any indication [4,5].…”