Procedure of endoscopic hemostasis using a distal attachment and short clips against upper gastrointestinal bleeding

Abstract

Endoscopic hemostasis using a distal attachment and short clips against upper gastrointestinal bleeding was performed. Subjects were 66 patients with 80 lesions upper gastrointestinal bleeding. Appropriate endoscopic view using a distal attachment was achieved in all patients. This procedure has been performed against 36 lesions, including 14 of gastric ulcer, 10 of duodenal ulcer, 9 of endoscopic resected lesion against early gastric cancer and gastric adenoma and 3 of Mallory-Weiss syndrome. For tangent view-lesions, this attachment has made endoscopic observation and treatment more easier. In addition, the entire short clip was able to be stored into this attachment, and certainly clamped against a protruded visible vessel. Thirty-four of 36 lesions (94.4%) had temporal hemostasis and thirty-three lesions (91.7%) had permanent hemostasis. One patient with multiple gastric ulcers with advanced hepatocellular carcinoma and bleeding tendency had temporal hemostasis, however he died of rebleeding from the ulcers associated with DIC. The second patient with duodenal ulcer in the superior duodenal flexure underwent interventional radiology, and the third patient with duodenal Dieulafoy's ulcer close to papilla of Vater underwent endoscopic short clip hemostasis using a lateral-viewing endoscope.
Endoscopic hemostasis with a distal attachment and short clips is useful for upper gastrointestinal bleeding.