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Comparison of hemostasis using bipolar hemostatic forceps with hemostasis by endoscopic hemoclipping for nonvariceal upper gastrointestinal bleeding in a prospective non-randomized trial

Abstract

Background

We previously reported on the safety and efficacy of bipolar hemostatic forceps for treating nonvariceal upper gastrointestinal (UGI) bleeding. However, no prospective or randomized studies have evaluated the efficacy of bipolar hemostatic forceps. The aim of this study was to evaluate the hemostatic efficacy of using bipolar hemostatic forceps compared with the hemostatic efficacy of the commonly used method of endoscopic hemoclipping for treating nonvariceal UGI bleeding.

Methods

A total of 50 patients who required endoscopic hemostasis for UGI bleeding were divided into two groups: those who underwent endoscopic hemostasis using bipolar hemostatic forceps (Group I) and those who underwent endoscopic hemostasis by endoscopic hemoclipping (Group II). We compared the two groups in terms of hemostasis success rate and time required to achieve hemostasis and stop recurrent bleeding.

Results

All (100 %) of 27 patients in Group I and 18 (78.2 %) of 23 patients in Group II were successfully treated using bipolar hemostatic forceps or by endoscopic hemoclipping alone, respectively, indicating a significantly higher success rate for Group I than for Group II (p < 0.05). The time required to achieve hemostasis was 6.8 ± 13.4 min for Group I and 15.4 ± 17.0 min for Group II. One patient in Group I (3.7 %) and four patients in Group II (22.2 %) experienced recurrent bleeding.

Conclusion

Bipolar hemostatic forceps was more effective than endoscopic hemoclipping for treating nonvariceal UGI bleeding.

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References

  1. 1.

    Kakushima N, Fujishiro M (2008) Endoscopic submucosal dissection for gastrointestinal neoplasms. World J Gastroenterol 14:2362–2367

  2. 2.

    Takizawa K, Oda I, Gotoda T, Yokoi C, Matsuda T, Saito Y et al (2008) Routine coagulation of visible vessels may prevent delayed bleeding after endoscopic submucosal dissection. Endoscopy 40:179–183

  3. 3.

    Sugiyama T, Dozaiku T, Toyonaga T et al (2006) The usefulness of 4 + 1 contact method using soft coagulation for bleeding gastric ulcers. Gastroenterol Endosc 48:204–211

  4. 4.

    Fujishiro M, Abe N, Endou M et al (2010) Retrospective multicenter study concerning electrocautery forceps with soft coagulation for nonmalignant gastroduodenal ulcer bleeding in Japan. Dig Endosc 22:S15–S18

  5. 5.

    Fujishiro M, Abe N, Endou M et al (2010) Current managements and outcomes of peptic and artificial ulcer bleeding in Japan. Dig Endosc 22:S9–S14

  6. 6.

    Kataoka M, Kawai T, Yagi K et al (2010) Clinical evaluation of emergency endoscopic hemostasis with bipolar forceps in non-variceal upper gastrointestinal bleeding. Dig Endosc 22:151–155

  7. 7.

    Kubba AK, Palmer KR (1996) Role of endoscopic injection therapy in the treatment of bleeding peptic ulcer. Br J Surg 83(4):461–468

  8. 8.

    Hachisu T (1988) Evaluation of endoscopic hemostasis using an improved clipping apparatus. Surg Endosc 2:13–17

  9. 9.

    Ohta S, Yukioka T, Ohta S et al (1996) Hemostasis with endoscopic hemoclipping for severe gastrointestinal bleeding in critically ill patients. Am J Gstroenterol 91:701–704

  10. 10.

    Nagayama K, Tazawa J, Sakai Y et al (1999) Efficacy of endoscopic clipping for bleeding gastrointestinal ulcer: Comparison with topical ethanol injection. Am J Gastroenterol 94:2897–2901

  11. 11.

    Takizawa K, Oda I, Gotoda T et al (2008) Routine coagulation of visible vessels may prevent delayed bleeding after endoscopic submucosal dissection—an analysis of risk factors. Endoscopy 40:179–183

  12. 12.

    Yahagi N (2005) Devices for therapeutic incision and dissection—Bipolar hemostatic forceps. Dig Endosc 17:896–897

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Acknowledgments

This study was supported by a Grant from Tokyo Medical University. We are also indebted to Mr. Roderick J. Turner, Associate Professor Edward F. Barroga, and Professor J. Patrick Barron, Chairman of the Department of International Medical Communications at Tokyo Medical University, for their editorial review of the English manuscript.

Disclosures

Drs. Mikinori Kataoka, Takashi Kawai, Yasutaka Hayama, Kei Yamamoto, Masaya Nonaka, Takaya Aoki, Kenji Yagi, Mari Fukuzawa, Masakatsu Fukuzawa, and Fuminori Moriyasu have no conflicts of interest or financial ties to disclose.

Author information

Correspondence to Mikinori Kataoka.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Video: Case presentation: Hemorrhagic gastric ulcer of the antrum along the lesser curvature. (WMV 3450 kb)

Video: Case presentation: Hemostasis by coagulation was achieved through application of electricity with the bipolar forceps kept open and compressed, without causing dislocation. (WMV 4935 kb)

Video: Case presentation: Hemorrhagic gastric ulcer of the antrum along the lesser curvature. (WMV 3450 kb)

Video: Case presentation: Hemostasis by coagulation was achieved through application of electricity with the bipolar forceps kept open and compressed, without causing dislocation. (WMV 4935 kb)

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Kataoka, M., Kawai, T., Hayama, Y. et al. Comparison of hemostasis using bipolar hemostatic forceps with hemostasis by endoscopic hemoclipping for nonvariceal upper gastrointestinal bleeding in a prospective non-randomized trial. Surg Endosc 27, 3035–3038 (2013). https://doi.org/10.1007/s00464-013-2860-4

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Keywords

  • Bipolar forceps
  • Gastrointestinal ulcers
  • Endoscopy
  • Hemostasis