Endoscopic hemoclip versus triclip placement in patients with high-risk peptic ulcer bleeding

Am J Gastroenterol. 2007 Mar;102(3):539-43. doi: 10.1111/j.1572-0241.2006.00962.x.

Abstract

Background: Hemoclip placement is an effective endoscopic therapy for peptic ulcer bleeding. Triclip is a novel clipping device with three prongs over the distal end. So far, there is no clinical study concerning the hemostatic effect of triclip placement.

Aim: To determine the hemostatic effect of the triclip as compared with that of the hemoclip.

Methods: A total of 100 peptic ulcer patients with active bleeding or nonbleeding visible vessels received endoscopic therapy with either hemoclip (N = 50) or triclip placement (N = 50). After obtaining initial hemostasis, they received omeprazole 40 mg intravenous infusion every 12 h for 3 days. The main outcome assessment was hemostatic rate and rebleeding rate at 14 days.

Results: Initial hemostasis was obtained in 47 patients (94%) of the hemoclip group and in 38 patients (76%) of the triclip group (P= 0.011). Rebleeding episodes, volume of blood transfusion, the hospital stay, numbers of patients requiring urgent operation, and mortality were not statistically different between the two groups.

Conclusion: Hemoclip is superior to triclip in obtaining primary hemostasis in patients with high-risk peptic ulcer bleeding. In bleeders located over difficult-to-approach sites, hemoclip is more ideal than triclip.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Endoscopy, Gastrointestinal / methods
  • Equipment Design
  • Female
  • Follow-Up Studies
  • Hemostasis, Endoscopic / instrumentation*
  • Humans
  • Length of Stay
  • Male
  • Peptic Ulcer Hemorrhage / diagnosis
  • Peptic Ulcer Hemorrhage / epidemiology
  • Peptic Ulcer Hemorrhage / therapy*
  • Prevalence
  • Recurrence
  • Retrospective Studies
  • Survival Rate
  • Taiwan / epidemiology
  • Treatment Outcome
  • Video Recording