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Surgical Endoscopy

, Volume 27, Issue 9, pp 3162–3164 | Cite as

Over-the-scope clip (OTSC) represents an effective endoscopic treatment for acute GI bleeding after failure of conventional techniques

  • Raffaele Manta
  • Giuseppe Galloro
  • Benedetto Mangiavillano
  • Rita Conigliaro
  • Luigi Pasquale
  • Alberto Arezzo
  • Enzo Masci
  • Gabrio Bassotti
  • Marzio Frazzoni
Article

Abstract

Background

Through-the-scope clips are commonly used for endoscopic hemostasis of gastrointestinal (GI) bleeding, but their efficacy can be suboptimal in patients with complex bleeding lesions. The over-the-scope clip (OTSC) could overcome the limitations of through-the-scope clips by allowing compression of larger amounts of tissue, allowing a more efficient hemostasis. We analyzed the use of OTSC in a consecutive case series of patients with acute GI bleeding unresponsive to conventional endoscopic treatment modalities.

Methods

In a retrospective analysis of prospectively collected data in tertiary referral centers, patients undergoing emergency endoscopy for severe acute nonvariceal GI bleeding were treated with the OTSC after failure of conventional techniques. All patients underwent repeat endoscopy 2–4 days after the procedure. Data analysis included primary hemostasis, complications, and 1-month follow-up clinical outcome.

Results

During a 10-month period, 30 patients entered the study consecutively. Bleeding lesions unresponsive to conventional endoscopic treatment (saline/adrenaline injection and through-the-scope clipping) were located in the upper and lower GI tract in 23 and 7 cases, respectively. Primary hemostasis was achieved in 29 of 30 cases (97 %). One patient with bleeding from duodenal bulb ulcer required emergent selective radiological embolization. Rebleeding occurred in two patients 12 and 24 h after the procedure; they were successfully treated with conventional saline/adrenaline endoscopic injection.

Conclusions

OTSC is an effective and safe therapeutic option for severe acute GI bleeding when conventional endoscopic treatment modalities fail.

Keywords

Gastrointestinal bleeding Hemostasis Over-the-scope clip 

Notes

Disclosures

Raffaele Manta, Giuseppe Galloro, Benedetto Mangiavillano, Luigi Pasquale, Alberto Arezzo, Rita Conigliaro, Enzo Masci, Gabrio Bassotti, and Marzio Frazzoni have no conflicts of interest or financial ties to disclose.

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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Raffaele Manta
    • 1
  • Giuseppe Galloro
    • 2
  • Benedetto Mangiavillano
    • 3
  • Rita Conigliaro
    • 1
  • Luigi Pasquale
    • 4
  • Alberto Arezzo
    • 5
  • Enzo Masci
    • 3
  • Gabrio Bassotti
    • 6
  • Marzio Frazzoni
    • 7
  1. 1.Gastroenterology and Endoscopy UnitNew S. Agostino HospitalModenaItaly
  2. 2.Surgical Digestive Endoscopy Unit, Department of General, Geriatric, Oncologic Surgery and Advanced TechnologiesFederico II University School of MedicineNaplesItaly
  3. 3.Gastroenterology and Gastrointestinal Endoscopy UnitSan Paolo University HospitalMilanItaly
  4. 4.Gastroenterology and Endoscopy UnitS. Ottone Frangipane HospitalAriano IrpinoItaly
  5. 5.Center for Minimally Invasive SurgeryUniversity of TorinoTorinoItaly
  6. 6.Department of Clinical and Experimental Medicine, Gastroenterology and Hepatology SectionUniversity of PerugiaPerugiaItaly
  7. 7.Digestive Pathophysiology UnitNew S. Agostino HospitalModenaItaly

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