Endoclips versus heater probe in preventing early recurrent bleeding from peptic ulcer: a prospective and randomized trial

Gastrointest Endosc. 2001 Feb;53(2):147-51. doi: 10.1067/mge.2001.111386.


Background: Endoscopic application of hemoclips (HC) was prospectively compared with heat probe (HP) treatment in patients with bleeding ulcers.

Methods: One hundred thirteen patients with major stigmata of ulcer hemorrhage were randomly assigned to receive HP (n = 57) or HC (n = 56). Clinical and endoscopic features were comparable in both groups. Recurrent bleeding was retreated with the modality previously used. Patients in whom treatment or retreatment was unsuccessful underwent emergency surgery.

Results: Hemostasis, adequate treatment of visible vessel, 30-day mortality, and emergency surgery rates were similar for both groups. Recurrent bleeding was 21% for HP and 1.8% for HC (p < 0.05). Length of hospital stay and transfusion requirements were significantly lower in the HC group. There was no evidence of clip-induced tissue injury or impaired ulcer healing. Clips dislodged spontaneously in most patients within 8 weeks of treatment. No further hemorrhage occurred on a median follow-up of 11 months (range 1-23).

Conclusions: The hemoclip is safe and effective in the treatment of severe ulcer bleeding and is superior to HP in preventing early recurrent bleeding.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Female
  • Humans
  • Hyperthermia, Induced*
  • Male
  • Middle Aged
  • Peptic Ulcer Hemorrhage / prevention & control*
  • Peptic Ulcer Hemorrhage / therapy
  • Prospective Studies
  • Recurrence
  • Surgical Instruments*
  • Time Factors