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Endoscopic clipping in non-variceal upper gastrointestinal bleeding treatment

  • Giuseppe Galloro (Surgical Endoscopy Unit, Department of Clinical Medicine and Surgery, Federico II University of Naples) ;
  • Angelo Zullo (Gastroenterology and Digestive Endoscopy Unit, Nuovo Regina Margherita Hospital) ;
  • Gaetano Luglio (Surgical Endoscopy Unit, Department of Clinical Medicine and Surgery, Federico II University of Naples) ;
  • Alessia Chini (Surgical Endoscopy Unit, Department of Clinical Medicine and Surgery, Federico II University of Naples) ;
  • Donato Alessandro Telesca (Gastroenterology and Digestive Endoscopy Unit, San Carlo Hospital) ;
  • Rosa Maione (Surgical Endoscopy Unit, Department of Clinical Medicine and Surgery, Federico II University of Naples) ;
  • Matteo Pollastro (Surgical Endoscopy Unit, Department of Clinical Medicine and Surgery, Federico II University of Naples) ;
  • Giovanni Domenico De Palma (Surgical Endoscopy Unit, Department of Clinical Medicine and Surgery, Federico II University of Naples) ;
  • Raffaele Manta (Gastroenterology and Digestive Endoscopy Unit, General Hospital)
  • Received : 2021.09.30
  • Accepted : 2022.01.05
  • Published : 2022.05.30

Abstract

Since the earliest reports, advanced clipping systems have been developed, and it is possible to choose among many models with different structural and technical features. The main drawback of through-the-scope clips is their small size, which allows the compression of limited amounts of tissue needed for large-size vessel treatment. Therefore, the over-the-scope clip system was realized, allowing a larger and stronger mechanical compression of large tissue areas, with excellent results in achieving a definitive hemostasis in difficult cases. Many studies have analyzed the indications and efficacy of two-pronged endoclips and have shown good results for initial and permanent hemostasis. The aim of this review was to provide updated information on indications, positioning techniques, and results of clip application for endoscopic treatment of upper gastrointestinal non-variceal bleeding lesions.

Keywords

References

  1. Hearnshaw SA, Logan RF, Lowe D, et al. Acute upper gastrointestinal bleeding in the UK: patient characteristics, diagnoses and outcomes in the 2007 UK audit. Gut 2011;60:1327-1335.  https://doi.org/10.1136/gut.2010.228437
  2. van Leerdam ME. Epidemiology of acute upper gastrointestinal bleeding. Best Pract Res Clin Gastroenterol 2008;22:209-224.  https://doi.org/10.1016/j.bpg.2007.10.011
  3. van Leerdam ME, Vreeburg EM, Rauws EA, et al. Acute upper GI bleeding: did anything change? Time trend analysis of incidence and outcome of acute upper GI bleeding between 1993/1994 and 2000. Am J Gastroenterol 2003;98:1494-1499.  https://doi.org/10.1111/j.1572-0241.2003.07517.x
  4. Lanas A, Garcia-Rodriguez LA, Polo-Tomas M, et al. Time trends and impact of upper and lower gastrointestinal bleeding and perforation in clinical practice. Am J Gastroenterol 2009;104:1633-1641.  https://doi.org/10.1038/ajg.2009.164
  5. Jang JY. Recent developments in the endoscopic treatment of patients with peptic ulcer bleeding. Clin Endosc 2016;49:417-420.  https://doi.org/10.5946/ce.2016.135
  6. Chan CY, Yau KK, Siu WT, et al. Endoscopic hemostasis by using the TriClip for peptic ulcer hemorrhage: a pilot study. Gastrointest Endosc 2008;67:35-39.  https://doi.org/10.1016/j.gie.2007.05.042
  7. Guo SB, Gong AX, Leng J, et al. Application of endoscopic hemoclips for nonvariceal bleeding in the upper gastrointestinal tract. World J Gastroenterol 2009;15:4322-4326.  https://doi.org/10.3748/wjg.15.4322
  8. Gralnek IM, Dumonceau JM, Kuipers EJ, et al. Diagnosis and management of nonvariceal upper gastrointestinal hemorrhage: European Society of Gastrointestinal Endoscopy (ESGE) Guideline. Endoscopy 2015;47:a1-a46.  https://doi.org/10.1055/s-0034-1393172
  9. Hayashi T, Yonezawa M, Kawabara T, et al. The study on stanch clip for the treatment by endoscopy. Gastroenterol Endosc 1975;17:92-101. 
  10. Binmoeller KF, Thonke F, Soehendra N. Endoscopic hemoclip treatment for gastrointestinal bleeding. Endoscopy 1993;25:167-170.  https://doi.org/10.1055/s-2007-1010277
  11. Maiss J, Hochberger J, Schwab D. Hemoclips: which is the pick of the bunch? Gastrointest Endosc 2008;67:40-43.  https://doi.org/10.1016/j.gie.2007.07.010
  12. Romagnuolo J. Endoscopic clips: past, present and future. Can J Gastroenterol 2009;23:158-160.  https://doi.org/10.1155/2009/515937
  13. Hsu TC. Comparison of holding power of metal and absorbable hemostatic clips. Am J Surg 2006;191:68-71.  https://doi.org/10.1016/j.amjsurg.2004.12.006
  14. Saxena P, Ji-Shin E, Haito-Chavez Y, et al. Which clip? A prospective comparative study of retention rates of endoscopic clips on normal mucosa and ulcers in a porcine model. Saudi J Gastroenterol 2014;20:360-365.  https://doi.org/10.4103/1319-3767.145328
  15. Wang TJ, Aihara H, Thompson AC, et al. Choosing the right through-the-scope clip: a rigorous comparison of rotatability, whip, open/close precision, and closure strength (with videos). Gastrointest Endosc 2019;89:77-86.  https://doi.org/10.1016/j.gie.2018.07.025
  16. Manta R, Galloro G, Mangiavillano B, et al. Over-the-scope clip (OTSC) represents an effective endoscopic treatment for acute GI bleeding after failure of conventional techniques. Surg Endosc 2013;27:3162-3164.  https://doi.org/10.1007/s00464-013-2871-1
  17. Kirschniak A, Subotova N, Zieker D, et al. The over-the-scope clip (OTSC) for the treatment of gastrointestinal bleeding, perforations, and fistulas. Surg Endosc 2011;25:2901-2905.  https://doi.org/10.1007/s00464-011-1640-2
  18. Galloro G, Napolitano V, Magno L, et al. Diagnosis and therapeutic management of cystic dystrophy of the duodenal wall in heterotopic pancreas. A case report and revision of the literature. JOP 2008;9:725-732. 
  19. Manta R, Caruso A, Cellini C, et al. Endoscopic management of patients with post-surgical leaks involving the gastrointestinal tract: a large case series. United European Gastroenterol J 2016;4:770-777.  https://doi.org/10.1177/2050640615626051
  20. Manta R, Magno L, Conigliaro R, et al. Endoscopic repair of post-surgical gastrointestinal complications. Dig Liver Dis 2013;45:879-885.  https://doi.org/10.1016/j.dld.2013.03.008
  21. Manta R, Tremolaterra F, Arezzo A, et al. Complications during colonoscopy: prevention, diagnosis, and management. Tech Coloproctol 2015;19:505-513.  https://doi.org/10.1007/s10151-015-1344-z
  22. Kirschniak A, Kratt T, Stuker D, et al. A new endoscopic over-the-scope clip system for treatment of lesions and bleeding in the GI tract: first clinical experiences. Gastrointest Endosc 2007;66:162-167.  https://doi.org/10.1016/j.gie.2007.01.034
  23. Armellini E, Crino SF, Orsello M, et al. Novel endoscopic over-the-scope clip system. World J Gastroenterol 2015;21:13587-13592.  https://doi.org/10.3748/wjg.v21.i48.13587
  24. Park CH, Joo YE, Kim HS, et al. A prospective, randomized trial comparing mechanical methods of hemostasis plus epinephrine injection to epinephrine injection alone for bleeding peptic ulcer. Gastrointest Endosc 2004;60:173-179.  https://doi.org/10.1016/S0016-5107(04)01570-6
  25. Chou YC, Hsu PI, Lai KH, et al. A prospective, randomized trial of endoscopic hemoclip placement and distilled water injection for treatment of high-risk bleeding ulcers. Gastrointest Endosc 2003;57:324-328.  https://doi.org/10.1067/mge.2003.103
  26. Park CH, Joo YE, Kim HS, et al. A prospective, randomized trial of endoscopic band ligation versus endoscopic hemoclip placement for bleeding gastric Dieulafoy's lesions. Endoscopy 2004;36:677-681.  https://doi.org/10.1055/s-2004-825661
  27. Yamaguchi Y, Yamato T, Katsumi N, et al. Short-term and long-term benefits of endoscopic hemoclip application for Dieulafoy's lesion in the upper GI tract. Gastrointest Endosc 2003;57:653-656.  https://doi.org/10.1067/mge.2003.183
  28. Will U, Seidel T, Bosseckert H. Endoscopic hemoclip treatment for bleeding artificially induced Mallory-Weiss tears. Endoscopy 2002;34:748. 
  29. Huang SP, Wang HP, Lee YC, et al. Endoscopic hemoclip placement and epinephrine injection for Mallory-Weiss syndrome with active bleeding. Gastrointest Endosc 2002;55:842-846.  https://doi.org/10.1067/mge.2002.124560
  30. Sobrino-Faya M, Martinez S, Gomez Balado M, et al. Clips for the prevention and treatment of postpolypectomy bleeding (hemoclips in polypectomy). Rev Esp Enferm Dig 2002;94:457-462. 
  31. Baron TH, Norton ID, Herman L. Endoscopic hemoclip placement for post-sphincterotomy bleeding. Gastrointest Endosc 2000;52:662. 
  32. Boonpongmanee S, Fleischer DE, Pezzullo JC, et al. The frequency of peptic ulcer as a cause of upper-GI bleeding is exaggerated. Gastrointest Endosc 2004;59:788-794.  https://doi.org/10.1016/S0016-5107(04)00181-6
  33. Karstensen JG, Ebigbo A, Aabakken L, et al. Nonvariceal upper gastrointestinal hemorrhage: European Society of Gastrointestinal Endoscopy (ESGE) Cascade Guideline. Endosc Int Open 2018;6:E1256-E1263.  https://doi.org/10.1055/a-0677-2084
  34. Lin HJ, Hsieh YH, Tseng GY, et al. A prospective, randomized trial of endoscopic hemoclip versus heater probe thermocoagulation for peptic ulcer bleeding. Am J Gastroenterol 2002;97:2250-2254.  https://doi.org/10.1111/j.1572-0241.2002.05978.x
  35. Galloro G, De Palma GD, Siciliano S, et al. Secondary aortoduodenal fistula. Rare endoscopic finding in the course of digestive hemorrhage. Hepatogastroenterology 2000;47:1585-1587. 
  36. Lau J, Yu Y, Tang R, et al. Timing of endoscopy for acute upper gastrointestinal bleeding. N Engl J Med 2020;382:1299-1308.  https://doi.org/10.1056/NEJMoa1912484
  37. Saltzman JR, Strate LL, Di Sena V, et al. Prospective trial of endoscopic clips versus combination therapy in upper GI bleeding (PROTECCT--UGI bleeding). Am J Gastroenterol 2005;100:1503-1508.  https://doi.org/10.1111/j.1572-0241.2005.41561.x
  38. Sung JJ, Tsoi KK, Lai LH, et al. Endoscopic clipping versus injection and thermo-coagulation in the treatment of non-variceal upper gastrointestinal bleeding: a meta-analysis. Gut 2007;56:1364-1373.  https://doi.org/10.1136/gut.2007.123976
  39. Baracat F, Moura E, Bernardo W, et al. Endoscopic hemostasis for peptic ulcer bleeding: systematic review and meta-analyses of randomized controlled trials. Surg Endosc 2016;30:2155-2168.  https://doi.org/10.1007/s00464-015-4542-x
  40. Chan SM, Chiu PW, Teoh AY, et al. Use of the over-the-scope clip for treatment of refractory upper gastrointestinal bleeding: a case series. Endoscopy 2014;46:428-431.  https://doi.org/10.1055/s-0034-1364932
  41. Schmidt A, Golder S, Goetz M, et al. Over-the-scope clips are more effective than standard endoscopic therapy for patients with recurrent bleeding of peptic ulcers. Gastroenterology 2018;155:674-686.  https://doi.org/10.1053/j.gastro.2018.05.037
  42. Asokkumar R, Soetikno R, Sanchez-Yague A, et al. Use of over-the-scope-clip (OTSC) improves outcomes of high-risk adverse outcome (HR-AO) non-variceal upper gastrointestinal bleeding (NVUGIB). Endosc Int Open 2018;6:E789-E796.  https://doi.org/10.1055/a-0614-2390
  43. Rauws EA, Kool G, Bolwerk C. New approaches to endoscopic therapy for a haemostasis upper GI bleed. Scand J Gastroenterol Suppl 1996;218:116-123.  https://doi.org/10.3109/00365529609094741
  44. Hwang JH, Fisher DA, Ben-Menachem T, et al. The role of endoscopy in the management of acute non-variceal upper GI bleeding. Gastrointest Endosc 2012;75:1132-1138.  https://doi.org/10.1016/j.gie.2012.02.033
  45. Manta R, Mangiafico S, Zullo A, et al. First-line endoscopic treatment with over-the-scope clips in patients with either upper or lower gastrointestinal bleeding: a multicenter study. Endosc Int Open 2018;6:E1317-E1321.  https://doi.org/10.1055/a-0746-8435
  46. Mullady DK, Wang AY, Waschke KA. AGA clinical practice update on endoscopic therapies for non-variceal upper gastrointestinal bleeding: expert review. Gastroenterology 2020;159:1120-1128.  https://doi.org/10.1053/j.gastro.2020.05.095
  47. Lee S, Ahn JY, Jung HY, et al. Effective endoscopic treatment of Mallory-Weiss syndrome using Glasgow-Blatchford score and Forrest classification. J Dig Dis 2016;17:676-684.  https://doi.org/10.1111/1751-2980.12409
  48. Cho YS, Chae HS, Kim HK, et al. Endoscopic band ligation and endoscopic hemoclip placement for patients with Mallory-Weiss syndrome and active bleeding. World J Gastroenterol 2008;14:2080-2084.  https://doi.org/10.3748/wjg.14.2080
  49. Park CH, Sohn YH, Lee WS, et al. The usefulness of endoscopic hemoclipping for bleeding Dieulafoy lesions. Endoscopy 2003;35:388-392.  https://doi.org/10.1055/s-2003-38780
  50. Barakat M, Hamed A, Shady A, et al. Endoscopic band ligation versus endoscopic hemoclip placement for Dieulafoy's lesion: a meta-analysis. Eur J Gastroenterol Hepatol 2018;30:995-996.  https://doi.org/10.1097/MEG.0000000000001179
  51. Xavier AT, Campos JF, Robinson L, et al. Endoscopic clipping for gastrointestinal bleeding: emergency and prophylactic indications. Ann Gastroenterol 2020;33:563-570. 
  52. Tanaka S, Hayashi N, Oka S, et al. Endoscopic assessment of colorectal cancer with superficial or deep submucosal invasion using magnifying colonoscopy. Clin Endosc 2013;46:138-146.  https://doi.org/10.5946/ce.2013.46.2.138
  53. Martin Dominguez V, Diaz Mendez A, Santander C, et al. Portal hypertensive polyps, a new entity? Rev Esp Enferm Dig 2016;108:279-280. 
  54. Topal F, Akbulut S, Karahanli C, et al. Portal hypertensive polyps as gastroscopic finding in liver cirrhosis. Gastroenterol Res Pract 2020;2020:9058909. 
  55. Santoro GA, Aiello C, Galloro G, et al. Massive lower gastrointestinal hemorrhage in patients with portal hypertensive enteropathy: a report of two cases. Hepatogastroenterology 1997;44:1029-1032. 
  56. Gaspar JP, Stelow EB, Wang AY. Approach to the endoscopic resection of duodenal lesions. World J Gastroenterol 2016;22:600-617.  https://doi.org/10.3748/wjg.v22.i2.600
  57. Hara Y, Goda K, Dobashi A, et al. Short- and long-term outcomes of endoscopically treated superficial non-ampullary duodenal epithelial tumors. World J Gastroenterol 2019;25:707-718.  https://doi.org/10.3748/wjg.v25.i6.707
  58. An JY, Kim BW, Park JM, et al. Prophylactic clipping for the prevention of delayed complication after endoscopic resection for superficial non-ampullary duodenal tumor. Endoscopy 2019;51:S118. 
  59. An JY, Kim BW, Kim JS, et al. The use of endoscopic clipping in preventing delayed complications after endoscopic resection for superficial non-ampullary duodenal tumors. Clin Endosc 2021;54:563-569.  https://doi.org/10.5946/ce.2020.109
  60. Tsutsumi K, Kato M, Kakushima N, et al. Efficacy of endoscopic preventive procedures to reduce delayed adverse events after endoscopic resection of superficial nonampullary duodenal epithelial tumors: a meta-analysis of observational comparative trials. Gastrointest Endosc 2021;93:367-374.  https://doi.org/10.1016/j.gie.2020.08.017
  61. DiMaio CJ, Stevens PD. Nonvariceal upper gastrointestinal bleeding. Gastrointest Endosc Clin N Am 2007;17:253-272.  https://doi.org/10.1016/j.giec.2007.03.003
  62. Hepworth CC, Kadirkamanathan SS, Gong F, et al. A randomised controlled comparison of injection, thermal, and mechanical endoscopic methods of haemostasis on mesenteric vessels. Gut 1998;42:462-469.  https://doi.org/10.1136/gut.42.4.462
  63. Toka B, Eminler AT, Karacaer C, et al. Comparison of monopolar hemostatic forceps with soft coagulation versus hemoclip for peptic ulcer bleeding: a randomized trial (with video). Gastrointest Endosc 2019;89:792-802.  https://doi.org/10.1016/j.gie.2018.10.011
  64. Cipolletta L, Bianco MA, Marmo R, et al. Endoclips versus heater probe in preventing early recurrent bleeding from peptic ulcer: a prospective and randomized trial. Gastrointest Endosc 2001;53:147-151.  https://doi.org/10.1067/mge.2001.111386
  65. Gevers AM, De Goede E, Simoens M, et al. A randomized trial comparing injection therapy with hemoclip and with injection combined with hemoclip for bleeding ulcers. Gastrointest Endosc 2002;55:466-469.  https://doi.org/10.1067/mge.2002.112613
  66. Peng YC, Chen SY, Tung CF, et al. Factors associated with failure of initial endoscopic hemoclip hemostasis for upper gastrointestinal bleeding. J Clin Gastroenterol 2006;40:25-28.  https://doi.org/10.1097/01.mcg.0000190754.25750.c0
  67. Kobara H, Mori H, Nishiyama N, et al. Over-the-scope clip system: a review of 1517 cases over 9 years. J Gastroenterol Hepatol 2019;34:22-30.  https://doi.org/10.1111/jgh.14402
  68. Wedi E, von Renteln D, Gonzalez S, et al. Use of the over-the-scope-clip (OTSC) in non-variceal upper gastrointestinal bleeding in patients with severe cardiovascular comorbidities: a retrospective study. Endosc Int Open 2017;5:E875-E882.  https://doi.org/10.1055/s-0043-105496
  69. Amarnath S, Philipose J, Abergel J, et al. Over-the-scope clip to the rescue! A novel tool for refractory acute nonvariceal upper gastrointestinal hemorrhage. Case Rep Gastroenterol 2020;14:261-270. https://doi.org/10.1159/000507610