Complete endoscopic closure of gastric perforation induced by endoscopic resection of early gastric cancer using endoclips can prevent surgery (with video)

Gastrointest Endosc. 2006 Apr;63(4):596-601. doi: 10.1016/j.gie.2005.07.029.


Background: When gastric perforation occurs during endoscopic resection for early gastric cancer, a surgical treatment generally is performed. Considering the increasing number of EMRs and the possibility of perforation, our research sought to investigate whether endoscopic treatment for gastric perforation is possible.

Methods: From 1987 to 2004, 121 of 2460 patients who underwent gastric EMR at the National Cancer Center Hospital had gastric perforation during EMR (4.9%). The initial 4 patients were treated with emergent surgery. The subsequent 117 patients who were treated with endoclips formed our study population.

Results: Endoscopic closure with endoclips in 115 patients (98.3%) was successful. Two patients with unsuccessful endoscopic closure underwent emergent surgery. In the past 6 years, patients with perforation during gastric EMR treated with endoscopic closure had a recovery rate similar to that of the nonperforation cases.

Conclusions: Gastric perforation during endoscopic resection can be conservatively treated by complete endoscopic closure with endoclips.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Endoscopy, Gastrointestinal* / adverse effects
  • Endoscopy, Gastrointestinal* / methods
  • Female
  • Follow-Up Studies
  • Gastrectomy / adverse effects*
  • Gastrectomy / instrumentation*
  • Humans
  • Intraoperative Complications
  • Male
  • Middle Aged
  • Reoperation
  • Retrospective Studies
  • Rupture / surgery
  • Stomach / injuries*
  • Stomach / surgery
  • Stomach Neoplasms / surgery*
  • Treatment Outcome