Novel clip device for prevention of bleeding after endoscopic papillectomy

Abstract

Objectives Recently, a novel clip device, SureClip ® (Micro‐Tech Co. Ltd., Nanjing, China), has been developed, which improved rotation and reopening performance. We aimed to assess the efficacy of the SureClip ® in prophylactic closure of the mucosal break after endoscopic papillectomy (EP) for ampullary neoplasm. Methods We retrospectively reviewed the medical records of 40 patients who underwent EP for ampullary neoplasms between October 2009 and March 2020. Prophylactic closure after resection was performed using the conventional clip between 2014 and 2018, and with the SureClip ® after 2019. The baseline characteristics, techniques, outcomes, and complications of EP were analyzed. Results The median age of the patients (25 males and 15 females) was 70 years. The en block resection rate was 82.5% and the curative resection rate was 80.0%. Histologically, 11 (27.5%) patients had malignancy. Prophylactic closure was performed in 29 (72.5%) patients (17 conventional clips, 12 SureClip ® ). Complications occurred in 18 (45.0%) patients, including postprocedure bleeding in 9 (22.5%) patients. However, no postprocedure bleeding was observed in the patients who received prophylactic closure using the SureClip ® ( p = 0.038). All other factors were not significantly correlated with postprocedure bleeding. The duration of hospital stay after EP was significantly shorter in patients treated with the SureClip ® compared to those treated with a conventional clip or without clips ( p < 0.05). Conclusions In the present study, prophylactic clipping of the mucosal break using the SureClip ® was effective in preventing bleeding after EP.

Multicenter comparative study on the usefulness of the optimal electrosurgical unit setting in endoscopic papillectomy for ampullary neoplasms (with video)

“…9 novel endoscopic clip devices with rotation, reopening, and repeated repositioning tions has been developed, and several recent studies have demonstrated the effectiveness of these novel clip devices for preventing delayed bleeding after EP. 10,15 In this study, we used a novel clip device in our VIO-EP group. As shown in Table 4, a bleeding point below the papilla was less common in the VIO-EP group with a novel clip device than in the ICC-EP group with the conventional clip device.…”

“…The value of preventive closure of the frenulum by clipping has been reported to reduce delayed bleeding after EP 9 . Furthermore, novel endoscopic clip devices with rotation, reopening, and repeated repositioning functions has been developed, and several recent studies have demonstrated the effectiveness of these novel clip devices for preventing delayed bleeding after EP 10,15 . In this study, we used a novel clip device in our VIO‐EP group.…”

Successful hemostasis for arterial bleeding in duodenal malignant lymphoma using reopenable clip

“…Bleeding from the tumor is difficult to stop endoscopically, and cases of vascular embolization and irradiation have been reported 2,3 . Recently, reopenable clips have been effective for uncontrolled bleeding in gastric endoscopic submucosal dissection 4 and prevention of bleeding after endoscopic papillectomy 5 . With a single reopenable clip, hemostasis can be confirmed before final deployment and be reliably achieved even in difficult cases.…”

Use of a novel clip-band device for difficult biliary cannulation due to papillary edema after precutting

“…Duodenoscopic clipping is often challenging because the duodenoscope elevator may disrupt the opening and rotation of the clip. However, the SureClip (Micro-Tech Co. Ltd., Nanjing, China), which provides enhanced rotational and re-opening performance, facilitates easier clipping while using a duodenoscope 1 . Recently, a novel clip-band device called the SureClip Traction Band (Micro-Tech Co. Ltd.) was developed and reported to be a useful traction device for endoscopic submucosal dissection 2 .…”